MARILYN J STOMBAUGH Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000783

License Status

INACTIVE

Business

First Name

MARILYN

Middle

Last Name

STOMBAUGH

Business Name

MARILYN J STOMBAUGH

Original Issue Date

02/17/1996

Effective Date

01/14/2020

Expiration Date

03/01/2022

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

01/06/2022