BARRY MICHAEL BLUMENTHAL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000197

License Status

NOT RENEWED

Business

First Name

BARRY MICHAEL

Last Name

BLUMENTHAL

Business Name

BARRY MICHAEL BLUMENTHAL

Original Issue Date

10/19/1979

Effective Date

10/19/1979

Expiration Date

03/01/1988

City

NORTH MIAMI BEACH

State

Zip

33160

County

FLORIDA

Ever Disciplined

LastModifiedDate

09/26/2006