LARRY JAY JENSEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****77

License Status

NOT RENEWED

Business

First Name

LARRY

Middle

JAY

Last Name

JENSEN

Business Name

LARRY JAY JENSEN

Original Issue Date

10/30/2007

Effective Date

10/30/2007

Expiration Date

03/01/2008

City

ROBINSON

State

Zip

62454

County

CRAWFORD

Ever Disciplined

LastModifiedDate

01/17/2008