DANA LAKATOS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000046

License Status

NOT RENEWED

Business

First Name

DANA

Last Name

LAKATOS

Business Name

DANA LAKATOS

Original Issue Date

11/05/1976

Effective Date

02/12/2020

Expiration Date

03/01/2022

City

SPARTA

State

Zip

62286

County

RANDOLPH

Ever Disciplined

LastModifiedDate

07/27/2022