RYAN JORDAN MINIER Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****81

License Status

INOPERATIVE

Business

First Name

RYAN

Middle

JORDAN

Last Name

MINIER

Business Name

RYAN JORDAN MINIER

Original Issue Date

08/24/2020

Effective Date

01/12/2022

Expiration Date

03/01/2024

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

12/06/2023