KRISTY LYNNE BLUME Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002663

License Status

INACTIVE

Business

First Name

KRISTY

Middle

LYNNE

Last Name

BLUME

Business Name

KRISTY LYNNE BLUME

Original Issue Date

11/17/2005

Effective Date

11/17/2005

Expiration Date

03/01/2006

City

ST LOUIS

State

Zip

63144

County

MISSOURI

Ever Disciplined

LastModifiedDate

10/09/2006