TRACIE MARIE KOEBCKE Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004390

License Status

INACTIVE

Business

First Name

TRACIE

Middle

MARIE

Last Name

KOEBCKE

Business Name

TRACIE MARIE KOEBCKE

Original Issue Date

08/08/2012

Effective Date

02/14/2014

Expiration Date

03/01/2016

City

RENSSELAER

State

Zip

47978

County

JASPER

Ever Disciplined

LastModifiedDate

03/25/2014