KRISTEN D BALLENTHIN Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003109

License Status

INACTIVE

Business

First Name

KRISTEN

Middle

Last Name

BALLENTHIN

Business Name

KRISTEN D BALLENTHIN

Original Issue Date

10/16/2007

Effective Date

01/28/2010

Expiration Date

03/01/2012

City

LITTLE CANADA

State

Zip

55117

County

MINNESOTA

Ever Disciplined

LastModifiedDate

12/07/2011