KELLY MINIHANE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003885

License Status

NOT RENEWED

Business

First Name

KELLY

Last Name

MINIHANE

Business Name

KELLY MINIHANE

Original Issue Date

09/21/2010

Effective Date

02/27/2012

Expiration Date

03/01/2014

City

MENDOTA

State

Zip

61342

County

LA SALLE

Ever Disciplined

LastModifiedDate

04/08/2014