MARCIE JOY KUMLIEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****22

License Status

NOT RENEWED

Business

First Name

MARCIE

Middle

JOY

Last Name

KUMLIEN

Business Name

MARCIE JOY KUMLIEN

Original Issue Date

04/11/2006

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

12/01/2010