SCOTT WALTER REANEY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****81

License Status

NOT RENEWED

Business

First Name

SCOTT

Middle

WALTER

Last Name

REANEY

Business Name

SCOTT WALTER REANEY

Original Issue Date

10/20/2010

Effective Date

10/20/2010

Expiration Date

03/01/2012

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

04/16/2012