TINCY MARY OOMMEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007491

License Status

NOT RENEWED

Business

First Name

TINCY

Middle

MARY

Last Name

OOMMEN

Business Name

TINCY MARY OOMMEN

Original Issue Date

01/15/2020

Effective Date

01/15/2020

Expiration Date

03/01/2022

City

SHELBY TOWNSHIP

State

Zip

48316

Ever Disciplined

LastModifiedDate

07/27/2022