KATIE N GARDNER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004348

License Status

NOT RENEWED

Business

First Name

KATIE

Middle

Last Name

GARDNER

Business Name

KATIE N GARDNER

Original Issue Date

07/12/2012

Effective Date

07/12/2012

Expiration Date

03/01/2014

City

CAMBRIDGE

State

Zip

02139

County

MASSACHUSETTS

Ever Disciplined

LastModifiedDate

04/08/2014