MARIA J PANIAMOGAN Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****89

License Status

INOPERATIVE

Business

First Name

MARIA

Middle

Last Name

PANIAMOGAN

Business Name

MARIA J PANIAMOGAN

Original Issue Date

11/04/2003

Effective Date

02/06/2020

Expiration Date

03/01/2022

City

CAPE GIRARDEAU

State

Zip

63701

Ever Disciplined

LastModifiedDate

01/03/2022