ELIZABETH BRANTLEY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007879

License Status

NOT RENEWED

Business

First Name

ELIZABETH

Last Name

BRANTLEY

Business Name

ELIZABETH BRANTLEY

Original Issue Date

08/12/2020

Effective Date

01/30/2022

Expiration Date

03/01/2024

City

WINSTON SALEM

State

Zip

27103

Ever Disciplined

LastModifiedDate

02/05/2025