STACY L SORLIE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****17

License Status

NOT RENEWED

Business

First Name

STACY

Middle

Last Name

SORLIE

Business Name

STACY L SORLIE

Original Issue Date

09/26/2002

Effective Date

02/17/2010

Expiration Date

03/01/2012

City

ATLANTA

State

Zip

30306

County

GEORGIA

Ever Disciplined

LastModifiedDate

04/12/2016