BERNA BUNGABONG MOORE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006189

License Status

NOT RENEWED

Business

First Name

BERNA

Middle

BUNGABONG

Last Name

MOORE

Business Name

BERNA BUNGABONG MOORE

Original Issue Date

05/02/2017

Effective Date

01/29/2022

Expiration Date

03/01/2024

City

SAN DIEGO

State

Zip

92121

Ever Disciplined

LastModifiedDate

02/05/2025