AMANDA BEHNEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****79

License Status

NOT RENEWED

Business

First Name

AMANDA

Last Name

BEHNEN

Business Name

AMANDA BEHNEN

Original Issue Date

04/08/2020

Effective Date

04/08/2020

Expiration Date

03/01/2022

City

MARYVILLE

State

Zip

62062

County

MADISON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022