SONYA C ETHRIDGE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****64

License Status

NOT RENEWED

Business

First Name

SONYA C

Last Name

ETHRIDGE

Business Name

SONYA C ETHRIDGE

Original Issue Date

06/10/2002

Effective Date

06/10/2002

Expiration Date

03/01/2006

City

VIENNA

State

Zip

62995

County

JOHNSON

Ever Disciplined

LastModifiedDate

10/09/2006