HEATHER J WAYNE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002556

License Status

NOT RENEWED

Business

First Name

HEATHER

Middle

Last Name

WAYNE

Business Name

HEATHER J WAYNE

Original Issue Date

09/02/2005

Effective Date

06/12/2008

Expiration Date

03/01/2010

City

ST LOUIS

State

Zip

63103

County

MISSOURI

Ever Disciplined

LastModifiedDate

12/27/2010