THERESA L CROWDER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002866

License Status

NOT RENEWED

Business

First Name

THERESA

Middle

Last Name

CROWDER

Business Name

THERESA L CROWDER

Original Issue Date

10/23/2006

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

GOODLAND

State

Zip

47948

County

INDIANA

Ever Disciplined

LastModifiedDate

04/01/2010