CORA LEE GIBBS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****65

License Status

NOT RENEWED

Business

First Name

CORA

Middle

LEE

Last Name

GIBBS

Business Name

CORA LEE GIBBS

Original Issue Date

11/01/2019

Effective Date

02/28/2022

Expiration Date

03/01/2024

City

KENOSHA

State

Zip

53140

Ever Disciplined

LastModifiedDate

02/05/2025