KRISTEN D BALLENTHIN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****31

License Status

NOT RENEWED

Business

First Name

KRISTEN

Middle

Last Name

BALLENTHIN

Business Name

KRISTEN D BALLENTHIN

Original Issue Date

12/07/2007

Effective Date

01/28/2010

Expiration Date

03/01/2012

City

NORTH ST PAUL

State

Zip

55109

County

MINNESOTA

Ever Disciplined

LastModifiedDate

04/16/2012