KRISTIN MARIE BLANKENSHIP Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004979

License Status

INACTIVE

Business

First Name

KRISTIN

Middle

MARIE

Last Name

BLANKENSHIP

Business Name

KRISTIN MARIE BLANKENSHIP

Original Issue Date

01/28/2014

Effective Date

01/28/2014

Expiration Date

03/01/2016

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/21/2016