MARCIE JOY KUMLIEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002677

License Status

NOT RENEWED

Business

First Name

MARCIE

Middle

JOY

Last Name

KUMLIEN

Business Name

MARCIE JOY KUMLIEN

Original Issue Date

12/22/2005

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

12/01/2010