CHRISTIN LEANNE FISHBACK Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****18

License Status

INOPERATIVE

Business

First Name

CHRISTIN

Middle

LEANNE

Last Name

FISHBACK

Business Name

CHRISTIN LEANNE FISHBACK

Original Issue Date

10/17/2012

Effective Date

10/17/2012

Expiration Date

03/01/2014

City

BELLEVILLE

State

Zip

62221

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

04/16/2013