CARYN MARIE SELBY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****87

License Status

NOT RENEWED

Business

First Name

CARYN

Middle

MARIE

Last Name

SELBY

Business Name

CARYN MARIE SELBY

Original Issue Date

09/17/2012

Effective Date

01/23/2020

Expiration Date

03/01/2022

City

MOUNT CARMEL

State

Zip

62863

County

WABASH

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022