AMY LOUISE BLOOMFIELD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****85

License Status

NOT RENEWED

Business

First Name

AMY

Middle

LOUISE

Last Name

BLOOMFIELD

Business Name

AMY LOUISE BLOOMFIELD

Original Issue Date

03/16/2016

Effective Date

03/16/2016

Expiration Date

03/01/2018

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

12/11/2018