MAXINE CYPRIEN BELFORT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007815

License Status

NOT RENEWED

Business

First Name

MAXINE

Middle

CYPRIEN

Last Name

BELFORT

Business Name

MAXINE CYPRIEN BELFORT

Original Issue Date

07/07/2020

Effective Date

07/07/2020

Expiration Date

03/01/2022

City

SPRING VALLEY

State

Zip

10977

Ever Disciplined

LastModifiedDate

07/27/2022