REBECCA MAUREEN JOHNSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002312

License Status

NOT RENEWED

Business

First Name

REBECCA

Middle

MAUREEN

Last Name

JOHNSON

Business Name

REBECCA MAUREEN JOHNSON

Original Issue Date

09/02/2004

Effective Date

02/18/2020

Expiration Date

03/01/2022

City

NEW YORK

State

Zip

10016

County

NEW YORK

Ever Disciplined

LastModifiedDate

07/27/2022