RENEE NICOLE RUTHERFORD 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

RENEE

Middle

NICOLE

Last Name

RUTHERFORD

Business Name

RENEE NICOLE RUTHERFORD

Original Issue Date

12/06/2007

Effective Date

08/04/2011

Expiration Date

03/01/2012

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

04/16/2012