AMANDA RAE REANEY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****85

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

RAE

Last Name

REANEY

Business Name

AMANDA RAE REANEY

Original Issue Date

03/09/2011

Effective Date

03/09/2011

Expiration Date

03/01/2012

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

09/04/2013