SALLY Y SA - Physician Assistant License in New York | # 085003371

SALLY Y SA

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003371

License Status

NOT RENEWED

Business

N

First Name

SALLY

Middle

Y

Last Name

SA

Business Name

SALLY Y SA

Original Issue Date

10/23/2008

Effective Date

03/01/2010

Expiration Date

03/01/2012

State

NY

Ever Disciplined

N

LastModifiedDate

04/11/2012