KRISTEN D BALLENTHIN - Physician Assistant License in Minnesota | # 38*****31

KRISTEN D BALLENTHIN

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****31

License Status

NOT RENEWED

Business

N

First Name

KRISTEN

Middle

D

Last Name

BALLENTHIN

Business Name

KRISTEN D BALLENTHIN

Original Issue Date

12/07/2007

Effective Date

01/28/2010

Expiration Date

03/01/2012

State

MN

Ever Disciplined

N

LastModifiedDate

04/16/2012