KATHLEEN ELIZABETH KLECKNER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003900

License Status

NOT RENEWED

Business

First Name

KATHLEEN

Middle

ELIZABETH

Last Name

KLECKNER

Business Name

KATHLEEN ELIZABETH KLECKNER

Original Issue Date

09/24/2010

Effective Date

03/02/2012

Expiration Date

03/01/2014

City

INDIANAPOLIS

State

Zip

46240

Ever Disciplined

LastModifiedDate

04/08/2014