MOLLIE J BERG - Physician Assistant License in Wisconsin | # 085003481

MOLLIE J BERG

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003481

License Status

INACTIVE

Business

N

First Name

MOLLIE

Middle

J

Last Name

BERG

Business Name

MOLLIE J BERG

Original Issue Date

06/25/2009

Effective Date

06/25/2009

Expiration Date

03/01/2010

State

WI

Ever Disciplined

N

LastModifiedDate

09/22/2010