SHEILA BRUN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002617

License Status

NOT RENEWED

Business

First Name

SHEILA

Last Name

BRUN

Business Name

SHEILA BRUN

Original Issue Date

10/07/2005

Effective Date

10/07/2005

Expiration Date

03/01/2006

City

WEST LAFAYETTE

State

Zip

47906

County

INDIANA

Ever Disciplined

LastModifiedDate

10/09/2006