ERIN LEIGH MICENHEIMER Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004262

License Status

INACTIVE

Business

First Name

ERIN

Middle

LEIGH

Last Name

MICENHEIMER

Business Name

ERIN LEIGH MICENHEIMER

Original Issue Date

12/21/2011

Effective Date

12/21/2011

Expiration Date

03/01/2014

City

SAINT LOUIS

State

Zip

63109

Ever Disciplined

LastModifiedDate

08/29/2016