ZESTA S R CHILDERS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****97

License Status

NOT RENEWED

Business

First Name

ZESTA

Middle

S R

Last Name

CHILDERS

Business Name

ZESTA S R CHILDERS

Original Issue Date

09/27/2012

Effective Date

09/27/2012

Expiration Date

03/01/2014

City

DECATUR

State

Zip

62526

County

MACON

Ever Disciplined

LastModifiedDate

10/07/2014