MICAH LYNN ANN CLUTTER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007766

License Status

NOT RENEWED

Business

First Name

MICAH

Middle

LYNN ANN

Last Name

CLUTTER

Business Name

MICAH LYNN ANN CLUTTER

Original Issue Date

06/17/2020

Effective Date

02/22/2022

Expiration Date

03/01/2024

City

MACHESNEY PARK

State

Zip

61115

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

02/05/2025