CORA LEE GIBBS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006924

License Status

NOT RENEWED

Business

First Name

CORA

Middle

LEE

Last Name

GIBBS

Business Name

CORA LEE GIBBS

Original Issue Date

01/24/2019

Effective Date

02/28/2022

Expiration Date

03/01/2024

City

KENOSHA

State

Zip

53140

Ever Disciplined

LastModifiedDate

02/05/2025