JENNIFER A GORHAM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005436

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

Last Name

GORHAM

Business Name

JENNIFER A GORHAM

Original Issue Date

03/05/2015

Effective Date

03/05/2015

Expiration Date

03/01/2016

City

SAINT LOUIS

State

Zip

63125

County

MISSOURI

Ever Disciplined

LastModifiedDate

04/25/2016