MARIANA FAYMAN 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

MARIANA

Last Name

FAYMAN

Business Name

MARIANA FAYMAN

Original Issue Date

11/12/2004

Effective Date

11/12/2004

Expiration Date

03/01/2008

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

04/23/2008