ANDREA L BACA Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002054

License Status

NOT RENEWED

Business

First Name

ANDREA

Middle

Last Name

BACA

Business Name

ANDREA L BACA

Original Issue Date

08/14/2003

Effective Date

08/14/2003

Expiration Date

03/01/2008

City

DENVER

State

Zip

80204

County

COLORADO

Ever Disciplined

LastModifiedDate

04/23/2008