ANGELA MARIE PROSISE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002151

License Status

NOT RENEWED

Business

First Name

ANGELA

Middle

MARIE

Last Name

PROSISE

Business Name

ANGELA MARIE PROSISE

Original Issue Date

10/23/2003

Effective Date

12/28/2011

Expiration Date

03/01/2014

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

04/08/2014