KEVEN ROYAL MOTTINGER - Physician Assistant License in Wisconsin | # 085001539

KEVEN ROYAL MOTTINGER

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001539

License Status

INACTIVE

Business

N

First Name

KEVEN

Middle

ROYAL

Last Name

MOTTINGER

Business Name

KEVEN ROYAL MOTTINGER

Original Issue Date

12/27/2000

Effective Date

12/27/2000

Expiration Date

03/01/2006

State

WI

Ever Disciplined

N

LastModifiedDate

10/09/2006