ROSE M PRADA Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000403

License Status

NOT RENEWED

Business

First Name

ROSE M

Last Name

PRADA

Business Name

ROSE M PRADA

Original Issue Date

03/17/1990

Effective Date

03/17/1990

Expiration Date

03/01/1992

City

ST LOUIS

State

Zip

63111

County

MISSOURI

Ever Disciplined

LastModifiedDate

09/26/2006