DANIELLE BLAIR Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004107

License Status

NOT RENEWED

Business

First Name

DANIELLE

Last Name

BLAIR

Business Name

DANIELLE BLAIR

Original Issue Date

08/15/2011

Effective Date

02/08/2016

Expiration Date

03/01/2018

City

DYER

State

Zip

46311

Ever Disciplined

LastModifiedDate

05/10/2018