TIFFANY E O'HERN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004675

License Status

NOT RENEWED

Business

First Name

TIFFANY

Middle

Last Name

O'HERN

Business Name

TIFFANY E O'HERN

Original Issue Date

06/06/2013

Effective Date

02/05/2014

Expiration Date

03/01/2016

City

DYER

State

Zip

46311

County

INDIANA

Ever Disciplined

LastModifiedDate

04/25/2016