CHRISTINE MICHELLE LISSY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007233

License Status

NOT RENEWED

Business

First Name

CHRISTINE

Middle

MICHELLE

Last Name

LISSY

Business Name

CHRISTINE MICHELLE LISSY

Original Issue Date

08/27/2019

Effective Date

08/27/2019

Expiration Date

03/01/2020

City

INDIANAPOLIS

State

Zip

46204

Ever Disciplined

LastModifiedDate

11/24/2020