KASAUNDRA RAE HEIBERGER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****06

License Status

NOT RENEWED

Business

First Name

KASAUNDRA

Middle

RAE

Last Name

HEIBERGER

Business Name

KASAUNDRA RAE HEIBERGER

Original Issue Date

11/18/2015

Effective Date

03/01/2018

Expiration Date

03/01/2020

City

MARYVILLE

State

Zip

62062

County

MADISON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020