ALLYSE MARIE MERVIN - Physician Assistant License in Wisconsin | # 085004502

ALLYSE MARIE MERVIN

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004502

License Status

NOT RENEWED

Business

N

First Name

ALLYSE

Middle

MARIE

Last Name

MERVIN

Business Name

ALLYSE MARIE MERVIN

Original Issue Date

10/16/2012

Effective Date

10/16/2012

Expiration Date

03/01/2014

State

WI

Ever Disciplined

N

LastModifiedDate

04/08/2014