DANIELLE NICOLE MILLER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****18

License Status

NOT RENEWED

Business

First Name

DANIELLE

Middle

NICOLE

Last Name

MILLER

Business Name

DANIELLE NICOLE MILLER

Original Issue Date

10/13/2011

Effective Date

12/28/2011

Expiration Date

03/01/2014

City

MARION

State

Zip

62959

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

02/05/2015