STEFANI MOMICH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008049

License Status

NOT RENEWED

Business

First Name

STEFANI

Last Name

MOMICH

Business Name

STEFANI MOMICH

Original Issue Date

10/30/2020

Effective Date

02/02/2022

Expiration Date

03/01/2024

City

MUNSTER

State

Zip

46321

Ever Disciplined

LastModifiedDate

02/05/2025