SUSAN LEE BOTT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000680

License Status

NOT RENEWED

Business

First Name

SUSAN LEE

Last Name

BOTT

Business Name

SUSAN LEE BOTT

Original Issue Date

03/28/1995

Effective Date

03/28/1995

Expiration Date

03/01/1996

City

GREENVILLE

State

Zip

62246

County

BOND

Ever Disciplined

LastModifiedDate

09/26/2006