WAYNE E BLEVINS JR Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****97

License Status

ACTIVE

Business

First Name

WAYNE

Middle

Last Name

BLEVINS

Suffix

Business Name

WAYNE E BLEVINS JR

Original Issue Date

04/23/2012

Effective Date

12/03/2025

Expiration Date

03/01/2028

City

CARLINVILLE

State

Zip

62626

County

MACOUPIN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025