KIRSTIN NALL WHITE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****26

License Status

NOT RENEWED

Business

First Name

KIRSTIN

Middle

NALL

Last Name

WHITE

Business Name

KIRSTIN NALL WHITE

Original Issue Date

08/11/2004

Effective Date

12/21/2009

Expiration Date

03/01/2012

City

ZION

State

Zip

60099

County

LAKE

Ever Disciplined

LastModifiedDate

12/02/2015