ANDRIA COLLETTE CARTER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001796

License Status

NOT RENEWED

Business

First Name

ANDRIA

Middle

COLLETTE

Last Name

CARTER

Business Name

ANDRIA COLLETTE CARTER

Original Issue Date

05/23/2002

Effective Date

05/23/2002

Expiration Date

03/01/2004

City

FORT WAYNE

State

Zip

46805

County

INDIANA

Ever Disciplined

LastModifiedDate

10/09/2006