MAHGEN LYNN KRUSE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****24

License Status

NOT RENEWED

Business

First Name

MAHGEN

Middle

LYNN

Last Name

KRUSE

Business Name

MAHGEN LYNN KRUSE

Original Issue Date

09/09/2010

Effective Date

09/09/2010

Expiration Date

03/01/2012

City

HIGHLAND PARK

State

Zip

60035

County

LAKE

Ever Disciplined

LastModifiedDate

09/16/2013