RENICE CHRISTINE BRIDGER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****03

License Status

NOT RENEWED

Business

First Name

RENICE

Middle

CHRISTINE

Last Name

BRIDGER

Business Name

RENICE CHRISTINE BRIDGER

Original Issue Date

05/21/2012

Effective Date

05/21/2012

Expiration Date

03/01/2014

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

10/25/2016