HEATHER J WAYNE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****89

License Status

NOT RENEWED

Business

First Name

HEATHER

Middle

Last Name

WAYNE

Business Name

HEATHER J WAYNE

Original Issue Date

09/28/2005

Effective Date

07/11/2008

Expiration Date

03/01/2010

City

DECATUR

State

Zip

62526

County

MACON

Ever Disciplined

LastModifiedDate

12/27/2010