MICHAEL LEROY MATTESON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001557

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

LEROY

Last Name

MATTESON

Business Name

MICHAEL LEROY MATTESON

Original Issue Date

02/07/2001

Effective Date

12/21/2011

Expiration Date

03/01/2014

City

LYNCHBURG

State

Zip

24503

Ever Disciplined

LastModifiedDate

04/08/2014