GRACE MARIE DANIELS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005921

License Status

NOT RENEWED

Business

First Name

GRACE

Middle

MARIE

Last Name

DANIELS

Business Name

GRACE MARIE DANIELS

Original Issue Date

07/27/2016

Effective Date

03/02/2018

Expiration Date

03/01/2020

City

WHITE BEAR LAKE

State

Zip

55110

Ever Disciplined

LastModifiedDate

11/24/2020