MERRICK KRAIG BUCKINGHAM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004715

License Status

NOT RENEWED

Business

First Name

MERRICK

Middle

KRAIG

Last Name

BUCKINGHAM

Business Name

MERRICK KRAIG BUCKINGHAM

Original Issue Date

07/15/2013

Effective Date

07/15/2013

Expiration Date

03/01/2014

City

ALBUQUERQUE

State

Zip

87102

County

NEW MEXICO

Ever Disciplined

LastModifiedDate

04/08/2014