LORI A STUPP BOBULA Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004287

License Status

NOT RENEWED

Business

First Name

LORI

Middle

Last Name

STUPP BOBULA

Business Name

LORI A STUPP BOBULA

Original Issue Date

02/22/2012

Effective Date

02/23/2018

Expiration Date

03/01/2020

City

CINCINNATI

State

Zip

45230

County

OHIO

Ever Disciplined

LastModifiedDate

11/24/2020