DOUGLAS ALAN EASTHAM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003810

License Status

NOT RENEWED

Business

First Name

DOUGLAS

Middle

ALAN

Last Name

EASTHAM

Business Name

DOUGLAS ALAN EASTHAM

Original Issue Date

08/02/2010

Effective Date

02/25/2016

Expiration Date

03/01/2018

City

FAYETTEVILLE

State

Zip

28312

Ever Disciplined

LastModifiedDate

05/10/2018