CARYN MARIE SELBY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004454

License Status

NOT RENEWED

Business

First Name

CARYN

Middle

MARIE

Last Name

SELBY

Business Name

CARYN MARIE SELBY

Original Issue Date

09/17/2012

Effective Date

01/21/2020

Expiration Date

03/01/2022

City

FORT BRANCH

State

Zip

47648

Ever Disciplined

LastModifiedDate

07/27/2022