KEITH BRYAN GUESS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****73

License Status

NOT RENEWED

Business

First Name

KEITH

Middle

BRYAN

Last Name

GUESS

Business Name

KEITH BRYAN GUESS

Original Issue Date

04/13/2001

Effective Date

02/11/2010

Expiration Date

03/01/2012

City

WARSAW

State

Zip

62379

County

HANCOCK

Ever Disciplined

LastModifiedDate

04/11/2012