MARILYN J STOMBAUGH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****77

License Status

NOT RENEWED

Business

First Name

MARILYN

Middle

Last Name

STOMBAUGH

Business Name

MARILYN J STOMBAUGH

Original Issue Date

03/23/2001

Effective Date

03/23/2001

Expiration Date

03/01/2006

City

BENTON

State

Zip

62812

County

FRANKLIN

Ever Disciplined

LastModifiedDate

11/17/2015