CHRISTIN LEANNE FISHBACK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004429

License Status

NOT RENEWED

Business

First Name

CHRISTIN

Middle

LEANNE

Last Name

FISHBACK

Business Name

CHRISTIN LEANNE FISHBACK

Original Issue Date

08/27/2012

Effective Date

08/27/2012

Expiration Date

03/01/2014

City

WILDWOOD

State

Zip

63011

County

MISSOURI

Ever Disciplined

LastModifiedDate

04/08/2014