MARY KATHRYN ROSENHAUER 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

MARY

Middle

KATHRYN

Last Name

ROSENHAUER

Business Name

MARY KATHRYN ROSENHAUER

Original Issue Date

11/12/2003

Effective Date

03/09/2018

Expiration Date

03/01/2020

City

CARBONDALE

State

Zip

62901

County

JACKSON

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

11/24/2020