MEGAN MAE PENFOLD - Physician Assistant License in Wisconsin | # 085003024

MEGAN MAE PENFOLD

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003024

License Status

NOT RENEWED

Business

N

First Name

MEGAN

Middle

MAE

Last Name

PENFOLD

Business Name

MEGAN MAE PENFOLD

Original Issue Date

08/20/2007

Effective Date

01/22/2010

Expiration Date

03/01/2012

State

WI

Ever Disciplined

N

LastModifiedDate

01/02/2015