PATRICK LEE VANDERWAL Perfusionist License verification

Business Entity

NOT RENEWED

License Type

Perfusionist

Description

LICENSED PERFUSIONIST

License Number

214000084

License Status

NOT RENEWED

Business

First Name

PATRICK

Middle

LEE

Last Name

VANDERWAL

Business Name

PATRICK LEE VANDERWAL

Original Issue Date

11/18/2002

Effective Date

02/14/2006

Expiration Date

04/30/2008

City

GREENDALE

State

Zip

53129

County

WISCONSIN

Ever Disciplined

LastModifiedDate

06/04/2008