MADISON PASCHAL BONHAM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004684

License Status

NOT RENEWED

Business

First Name

MADISON

Middle

PASCHAL

Last Name

BONHAM

Business Name

MADISON PASCHAL BONHAM

Original Issue Date

06/13/2013

Effective Date

03/01/2016

Expiration Date

03/01/2018

City

PORTLAND

State

Zip

97209

Ever Disciplined

LastModifiedDate

05/10/2018