WANDA SANTOS CIULLA Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****04

License Status

NOT RENEWED

Business

First Name

WANDA

Middle

SANTOS

Last Name

CIULLA

Business Name

WANDA SANTOS CIULLA

Original Issue Date

01/08/2001

Effective Date

03/12/2018

Expiration Date

03/01/2020

City

PARIS

State

Zip

61944

County

EDGAR

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

11/24/2020