DEBRA R BAUM Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002445

License Status

INACTIVE

Business

First Name

DEBRA

Middle

Last Name

BAUM

Business Name

DEBRA R BAUM

Original Issue Date

01/12/2005

Effective Date

01/12/2005

Expiration Date

03/01/2006

City

LA CROSSE

State

Zip

54603

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/09/2006