GLENN ERIC GIFFORD Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085010682

License Status

ACTIVE

Business

First Name

GLENN

Middle

ERIC

Last Name

GIFFORD

Business Name

GLENN ERIC GIFFORD

Original Issue Date

08/28/2024

Effective Date

12/30/2025

Expiration Date

03/01/2028

City

SPEARFISH

State

Zip

57783

Ever Disciplined

LastModifiedDate

12/30/2025