AMBER DIANE DEVINE - Physician Assistant License in Wisconsin | # 085004499

AMBER DIANE DEVINE

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004499

License Status

NOT RENEWED

Business

N

First Name

AMBER

Middle

DIANE

Last Name

DEVINE

Business Name

AMBER DIANE DEVINE

Original Issue Date

10/12/2012

Effective Date

10/12/2012

Expiration Date

03/01/2014

State

WI

Ever Disciplined

N

LastModifiedDate

04/08/2014