RENEE L BLAHA Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002219

License Status

INACTIVE

Business

First Name

RENEE

Middle

Last Name

BLAHA

Business Name

RENEE L BLAHA

Original Issue Date

03/04/2004

Effective Date

03/04/2004

Expiration Date

03/01/2006

City

ASHLAND

State

Zip

54806

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/09/2006