MICHELLE A BENJAMIN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000631

License Status

NOT RENEWED

Business

First Name

MICHELLE A

Last Name

BENJAMIN

Business Name

MICHELLE A BENJAMIN

Original Issue Date

10/15/1994

Effective Date

10/15/1994

Expiration Date

03/01/2004

City

LAKELAND

State

Zip

33812

Ever Disciplined

LastModifiedDate

10/09/2006