ERIC DAVID JOHNSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005049

License Status

NOT RENEWED

Business

First Name

ERIC

Middle

DAVID

Last Name

JOHNSON

Business Name

ERIC DAVID JOHNSON

Original Issue Date

05/08/2014

Effective Date

03/09/2016

Expiration Date

03/01/2018

City

SPRING LAKE

State

Zip

49456

Ever Disciplined

LastModifiedDate

05/10/2018