ANGELA R GENISIO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****99

License Status

NOT RENEWED

Business

First Name

ANGELA

Middle

Last Name

GENISIO

Business Name

ANGELA R GENISIO

Original Issue Date

04/25/2012

Effective Date

01/11/2022

Expiration Date

03/01/2024

City

GRANITE CITY

State

Zip

62040

County

MADISON

Ever Disciplined

LastModifiedDate

02/05/2025