CANDACE NICOLE GODWIN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004661

License Status

NOT RENEWED

Business

First Name

CANDACE

Middle

NICOLE

Last Name

GODWIN

Business Name

CANDACE NICOLE GODWIN

Original Issue Date

05/13/2013

Effective Date

05/13/2013

Expiration Date

03/01/2014

City

CAPE GIRARDEAU

State

Zip

63701

County

MISSOURI

Ever Disciplined

LastModifiedDate

04/08/2014