MICHELE NICOLE BRANDHAGEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005272

License Status

NOT RENEWED

Business

First Name

MICHELE

Middle

NICOLE

Last Name

BRANDHAGEN

Business Name

MICHELE NICOLE BRANDHAGEN

Original Issue Date

09/30/2014

Effective Date

09/30/2014

Expiration Date

03/01/2016

City

URBANA

State

Zip

61802

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

04/25/2016