KRISTINE AMY FOSTER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****15

License Status

NOT RENEWED

Business

First Name

KRISTINE

Middle

AMY

Last Name

FOSTER

Business Name

KRISTINE AMY FOSTER

Original Issue Date

05/16/2005

Effective Date

01/19/2010

Expiration Date

03/01/2012

City

CARROLLTON

State

Zip

62016

County

GREENE

Ever Disciplined

LastModifiedDate

04/11/2012