LISA M DI SANDRO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001964

License Status

NOT RENEWED

Business

First Name

LISA

Middle

Last Name

DI SANDRO

Business Name

LISA M DI SANDRO

Original Issue Date

12/31/2002

Effective Date

12/31/2002

Expiration Date

03/01/2004

City

SEWELL

State

Zip

08080

Ever Disciplined

LastModifiedDate

10/09/2006