RENEE NICOLE RUTHERFORD Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003107

License Status

INACTIVE

Business

First Name

RENEE

Middle

NICOLE

Last Name

RUTHERFORD

Business Name

RENEE NICOLE RUTHERFORD

Original Issue Date

10/15/2007

Effective Date

01/25/2010

Expiration Date

03/01/2012

City

GLEN CARBON

State

Zip

62034

County

MADISON

Ever Disciplined

LastModifiedDate

03/02/2012