DANIELLE NICOLE MILLER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004152

License Status

NOT RENEWED

Business

First Name

DANIELLE

Middle

NICOLE

Last Name

MILLER

Business Name

DANIELLE NICOLE MILLER

Original Issue Date

09/23/2011

Effective Date

12/28/2011

Expiration Date

03/01/2014

City

CARBONDALE

State

Zip

62902

County

JACKSON

Ever Disciplined

LastModifiedDate

02/05/2015