AMY DENISE WILVERT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003991

License Status

NOT RENEWED

Business

First Name

AMY

Middle

DENISE

Last Name

WILVERT

Business Name

AMY DENISE WILVERT

Original Issue Date

02/08/2011

Effective Date

04/02/2018

Expiration Date

03/01/2020

City

LACEY

State

Zip

98516

Ever Disciplined

LastModifiedDate

11/24/2020