RON LUTHER HAMM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001221

License Status

NOT RENEWED

Business

First Name

RON

Middle

LUTHER

Last Name

HAMM

Business Name

RON LUTHER HAMM

Original Issue Date

05/28/1999

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

EAGLE

State

Zip

83616

County

IDAHO

Ever Disciplined

LastModifiedDate

04/01/2010