ROBYN HOFFMANN DETTMAR Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****44

License Status

NOT RENEWED

Business

First Name

ROBYN

Middle

HOFFMANN

Last Name

DETTMAR

Business Name

ROBYN HOFFMANN DETTMAR

Original Issue Date

11/06/2002

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

09/23/2010