BRIANNE ELIZABETH ANCICH - Physician Assistant License in Indiana | # 085002633

BRIANNE ELIZABETH ANCICH

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002633

License Status

NOT RENEWED

Business

N

First Name

BRIANNE

Middle

ELIZABETH

Last Name

ANCICH

Business Name

BRIANNE ELIZABETH ANCICH

Original Issue Date

10/21/2005

Effective Date

10/21/2005

Expiration Date

03/01/2006

State

IN

Ever Disciplined

N

LastModifiedDate

10/09/2006