Information as of 01/19/2020

Last Updated by Licensee on 01/07/2020

Jaclyn Adele Blair PA-C
License#: 
Issue Date: 
0010-09708
01/07/2020
License Status: 
Renewal Date:
Active  
08/11/2020  
 Public Action: Yes
 See: Actions-Adverse & Administrative Tab
Licensee General Information
Active License
Reason CodeLicense NumberSubcategoryIssue DateExpire Date
 0010-09708PA-C01/07/2020 
Inactive License
North Carolina Hospital Admitting Privileges
Out of State Active/Inactive Licenses
Texas
Out of Country Active/Inactive Licenses
None Reported