AMANDA K KETTNER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002499

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

Last Name

KETTNER

Business Name

AMANDA K KETTNER

Original Issue Date

07/11/2005

Effective Date

07/11/2005

Expiration Date

03/01/2006

City

APPLETON

State

Zip

54915

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/09/2006