CHRISTEN MARIE DITMAR Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****43

License Status

NOT RENEWED

Business

First Name

CHRISTEN

Middle

MARIE

Last Name

DITMAR

Business Name

CHRISTEN MARIE DITMAR

Original Issue Date

11/05/2018

Effective Date

02/18/2020

Expiration Date

03/01/2022

City

DAVENPORT

State

Zip

52804

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022