HEATHER LYNN KLUCK Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002399

License Status

INACTIVE

Business

First Name

HEATHER

Middle

LYNN

Last Name

KLUCK

Business Name

HEATHER LYNN KLUCK

Original Issue Date

10/28/2004

Effective Date

01/26/2012

Expiration Date

03/01/2014

City

CLINTON

State

Zip

53525

Ever Disciplined

LastModifiedDate

12/19/2013