CARMEN SUE GRANDT Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001475

License Status

INACTIVE

Business

First Name

CARMEN SUE

Last Name

GRANDT

Business Name

CARMEN SUE GRANDT

Original Issue Date

11/08/2000

Effective Date

11/08/2000

Expiration Date

03/01/2004

City

FLORENCE

State

Zip

41042

County

KENTUCKY

Ever Disciplined

LastModifiedDate

10/09/2006