ERIN LEIGH MICENHEIMER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****92

License Status

NOT RENEWED

Business

First Name

ERIN

Middle

LEIGH

Last Name

MICENHEIMER

Business Name

ERIN LEIGH MICENHEIMER

Original Issue Date

04/10/2012

Effective Date

04/10/2012

Expiration Date

03/01/2014

State

Ever Disciplined

LastModifiedDate

03/28/2014