BRANDI VAN BOOVEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007524

License Status

NOT RENEWED

Business

First Name

BRANDI

Last Name

VAN BOOVEN

Business Name

BRANDI VAN BOOVEN

Original Issue Date

01/24/2020

Effective Date

01/24/2020

Expiration Date

03/01/2022

City

SAINT CHARLES

State

Zip

63303

Ever Disciplined

LastModifiedDate

07/27/2022