MELISSA B LIST Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002501

License Status

INACTIVE

Business

First Name

MELISSA

Middle

Last Name

LIST

Business Name

MELISSA B LIST

Original Issue Date

07/12/2005

Effective Date

01/16/2014

Expiration Date

03/01/2016

City

HOLLY SPRINGS

State

Zip

27540

Ever Disciplined

LastModifiedDate

03/17/2016