KRISTIN RICHELLE BUSS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004213

License Status

NOT RENEWED

Business

First Name

KRISTIN

Middle

RICHELLE

Last Name

BUSS

Business Name

KRISTIN RICHELLE BUSS

Original Issue Date

10/14/2011

Effective Date

02/26/2016

Expiration Date

03/01/2018

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/10/2018