CAROLYN MARIE BRUNNER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003859

License Status

NOT RENEWED

Business

First Name

CAROLYN

Middle

MARIE

Last Name

BRUNNER

Business Name

CAROLYN MARIE BRUNNER

Original Issue Date

09/14/2010

Effective Date

02/25/2014

Expiration Date

03/01/2016

City

SAINT LOUIS

State

Zip

63129

County

MISSOURI

Ever Disciplined

LastModifiedDate

04/25/2016