JENNIFER L GRACE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004276

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

Last Name

GRACE

Business Name

JENNIFER L GRACE

Original Issue Date

02/02/2012

Effective Date

02/02/2012

Expiration Date

03/01/2014

City

VALPARAISO

State

Zip

46383

County

INDIANA

Ever Disciplined

LastModifiedDate

04/08/2014