AMY MICHELLE FOLSOM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002246

License Status

NOT RENEWED

Business

First Name

AMY

Middle

MICHELLE

Last Name

FOLSOM

Business Name

AMY MICHELLE FOLSOM

Original Issue Date

05/28/2004

Effective Date

05/28/2004

Expiration Date

03/01/2006

City

CAPE GIRARDEAU

State

Zip

63701

County

MISSOURI

Ever Disciplined

LastModifiedDate

10/09/2006