ELANA M ROSE Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001158

License Status

INACTIVE

Business

First Name

ELANA

Middle

Last Name

ROSE

Business Name

ELANA M ROSE

Original Issue Date

01/12/1999

Effective Date

03/04/2014

Expiration Date

03/01/2016

City

PEWAUKEE

State

Zip

53072

County

WISCONSIN

Ever Disciplined

LastModifiedDate

01/21/2016