REX E STOMBAUGH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****91

License Status

NOT RENEWED

Business

First Name

REX

Middle

Last Name

STOMBAUGH

Business Name

REX E STOMBAUGH

Original Issue Date

03/23/2001

Effective Date

02/26/2010

Expiration Date

03/01/2012

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

11/17/2015