RAQUEL GRANT VENABLE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001494

License Status

NOT RENEWED

Business

First Name

RAQUEL

Middle

GRANT

Last Name

VENABLE

Business Name

RAQUEL GRANT VENABLE

Original Issue Date

12/01/2000

Effective Date

12/01/2000

Expiration Date

03/01/2002

City

SCHERERVILLE

State

Zip

46375

County

INDIANA

Ever Disciplined

LastModifiedDate

10/09/2006