JAYNE K FEDOR Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****54

License Status

NOT RENEWED

Business

First Name

JAYNE

Middle

Last Name

FEDOR

Business Name

JAYNE K FEDOR

Original Issue Date

11/21/2002

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Ever Disciplined

LastModifiedDate

02/10/2011