HEATHER FUNDERBURG KIRKPATRICK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005638

License Status

NOT RENEWED

Business

First Name

HEATHER

Middle

FUNDERBURG

Last Name

KIRKPATRICK

Business Name

HEATHER FUNDERBURG KIRKPATRICK

Original Issue Date

09/17/2015

Effective Date

02/25/2016

Expiration Date

03/01/2018

City

FAIRVIEW HEIGHTS

State

Zip

62208

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

05/10/2018