INGA LIESE STORBAKKEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003164

License Status

NOT RENEWED

Business

First Name

INGA

Middle

LIESE

Last Name

STORBAKKEN

Business Name

INGA LIESE STORBAKKEN

Original Issue Date

12/03/2007

Effective Date

03/03/2020

Expiration Date

03/01/2022

City

AUSTIN

State

Zip

78739

County

LAKE

Ever Disciplined

LastModifiedDate

07/27/2022