HALEY C MEDVICK Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****72

License Status

INOPERATIVE

Business

First Name

HALEY

Middle

Last Name

MEDVICK

Business Name

HALEY C MEDVICK

Original Issue Date

07/20/2010

Effective Date

03/07/2012

Expiration Date

03/01/2014

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

05/13/2013