LYDIA NICOLE MARQUEZ Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002630

License Status

NOT RENEWED

Business

First Name

LYDIA

Middle

NICOLE

Last Name

MARQUEZ

Business Name

LYDIA NICOLE MARQUEZ

Original Issue Date

10/19/2005

Effective Date

03/05/2014

Expiration Date

03/01/2016

City

SAINT JOHN

State

Zip

46373

County

INDIANA

Ever Disciplined

LastModifiedDate

04/25/2016