SEAN MICHAEL MILLER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****33

License Status

NOT RENEWED

Business

First Name

SEAN

Middle

MICHAEL

Last Name

MILLER

Business Name

SEAN MICHAEL MILLER

Original Issue Date

07/23/2015

Effective Date

07/23/2015

Expiration Date

03/01/2016

City

MARYVILLE

State

Zip

62062

County

MADISON

Ever Disciplined

LastModifiedDate

03/01/2016