SUSAN M AMUNDSEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000685

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

Last Name

AMUNDSEN

Business Name

SUSAN M AMUNDSEN

Original Issue Date

04/25/1995

Effective Date

03/02/2018

Expiration Date

03/01/2020

City

DUBUQUE

State

Zip

52001

Ever Disciplined

LastModifiedDate

11/24/2020