JENNIFER ANN STORM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003216

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

ANN

Last Name

STORM

Business Name

JENNIFER ANN STORM

Original Issue Date

05/14/2008

Effective Date

03/19/2019

Expiration Date

03/01/2020

City

SAINT LOUIS

State

Zip

63110

County

MISSOURI

Ever Disciplined

LastModifiedDate

11/24/2020