STEPHANIE MARIE KUMM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005317

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

MARIE

Last Name

KUMM

Business Name

STEPHANIE MARIE KUMM

Original Issue Date

10/14/2014

Effective Date

10/14/2014

Expiration Date

03/01/2016

City

PRIOR LAKE

State

Zip

55372

County

MINNESOTA

Ever Disciplined

LastModifiedDate

04/25/2016