BLAIR L LEWIS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000249

License Status

NOT RENEWED

Business

First Name

BLAIR L

Last Name

LEWIS

Business Name

BLAIR L LEWIS

Original Issue Date

04/01/1983

Effective Date

04/01/1983

Expiration Date

03/01/1998

City

FREDONIA

State

Zip

53021

County

WISCONSIN

Ever Disciplined

LastModifiedDate

09/26/2006