JODI LORENE BANGERT Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004131

License Status

ACTIVE

Business

First Name

JODI

Middle

LORENE

Last Name

BANGERT

Business Name

JODI LORENE BANGERT

Original Issue Date

09/16/2011

Effective Date

12/11/2023

Expiration Date

03/01/2026

City

LAKEVILLE

State

Zip

55044

Ever Disciplined

LastModifiedDate

12/03/2025