STACEY ANN BAUER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007083

License Status

NOT RENEWED

Business

First Name

STACEY

Middle

ANN

Last Name

BAUER

Business Name

STACEY ANN BAUER

Original Issue Date

06/19/2019

Effective Date

02/27/2020

Expiration Date

03/01/2022

City

RALEIGH

State

Zip

27612

Ever Disciplined

LastModifiedDate

07/27/2022