DEENA M MONTGOMERY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001798

License Status

NOT RENEWED

Business

First Name

DEENA M

Last Name

MONTGOMERY

Business Name

DEENA M MONTGOMERY

Original Issue Date

06/04/2002

Effective Date

06/04/2002

Expiration Date

03/01/2004

City

SESSER

State

Zip

62884

County

FRANKLIN

Ever Disciplined

LastModifiedDate

10/09/2006