KATHERINE A TETRAULT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003834

License Status

NOT RENEWED

Business

First Name

KATHERINE

Middle

Last Name

TETRAULT

Business Name

KATHERINE A TETRAULT

Original Issue Date

08/25/2010

Effective Date

02/27/2012

Expiration Date

03/01/2014

City

MACKINAW

State

Zip

61755

County

TAZEWELL

Ever Disciplined

LastModifiedDate

10/29/2015