CARMEN SUE GRANDT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****12

License Status

NOT RENEWED

Business

First Name

CARMEN SUE

Last Name

GRANDT

Business Name

CARMEN SUE GRANDT

Original Issue Date

03/26/2001

Effective Date

03/26/2001

Expiration Date

03/01/2004

City

WEST FRANKFORT

State

Zip

62896

County

FRANKLIN

Ever Disciplined

LastModifiedDate

09/26/2006