KEVEN ROYAL MOTTINGER Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001539

License Status

INACTIVE

Business

First Name

KEVEN

Middle

ROYAL

Last Name

MOTTINGER

Business Name

KEVEN ROYAL MOTTINGER

Original Issue Date

12/27/2000

Effective Date

12/27/2000

Expiration Date

03/01/2006

City

KENOSHA

State

Zip

53141

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/09/2006