JASON THOMAS DOUGLAS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004489

License Status

NOT RENEWED

Business

First Name

JASON

Middle

THOMAS

Last Name

DOUGLAS

Business Name

JASON THOMAS DOUGLAS

Original Issue Date

10/05/2012

Effective Date

10/05/2012

Expiration Date

03/01/2014

City

SHAWNEE

State

Zip

66203

County

KANSAS

Ever Disciplined

LastModifiedDate

04/08/2014