AMANDA CHRISTINE BLACK - Physician Assistant License in Missouri | # 085002890

AMANDA CHRISTINE BLACK

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002890

License Status

NOT RENEWED

Business

N

First Name

AMANDA

Middle

CHRISTINE

Last Name

BLACK

Business Name

AMANDA CHRISTINE BLACK

Original Issue Date

11/15/2006

Effective Date

11/15/2006

Expiration Date

03/01/2008

State

MO

Ever Disciplined

N

LastModifiedDate

04/23/2008