MIRNA CLERIE Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****16

License Status

INOPERATIVE

Business

First Name

MIRNA

Last Name

CLERIE

Business Name

MIRNA CLERIE

Original Issue Date

10/23/2021

Effective Date

02/08/2022

Expiration Date

03/01/2024

City

ZION

State

Zip

60099

County

LAKE

Ever Disciplined

LastModifiedDate

12/06/2023