KIRSTEN J ANTONNEAU - Physician Assistant License in Wisconsin | # 085004110

KIRSTEN J ANTONNEAU

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004110

License Status

NOT RENEWED

Business

N

First Name

KIRSTEN

Middle

J

Last Name

ANTONNEAU

Business Name

KIRSTEN J ANTONNEAU

Original Issue Date

08/24/2011

Effective Date

08/24/2011

Expiration Date

03/01/2012

State

WI

Ever Disciplined

N

LastModifiedDate

04/11/2012