MARY JO POREMBA Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001152

License Status

NOT RENEWED

Business

First Name

MARY JO

Last Name

POREMBA

Business Name

MARY JO POREMBA

Original Issue Date

01/11/1999

Effective Date

02/25/2016

Expiration Date

03/01/2018

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

05/10/2018