NATALIE S DESELEM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001119

License Status

NOT RENEWED

Business

First Name

NATALIE

Middle

Last Name

DESELEM

Business Name

NATALIE S DESELEM

Original Issue Date

01/11/1999

Effective Date

01/11/1999

Expiration Date

03/01/2006

City

YATES CITY

State

Zip

61572

County

KNOX

Ever Disciplined

LastModifiedDate

10/09/2006