VICKI P SMYTHE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001317

License Status

NOT RENEWED

Business

First Name

VICKI

Middle

Last Name

SMYTHE

Business Name

VICKI P SMYTHE

Original Issue Date

12/30/1999

Effective Date

01/13/2014

Expiration Date

03/01/2016

City

JANESVILLE

State

Zip

53545

County

WISCONSIN

Ever Disciplined

LastModifiedDate

04/25/2016