KATHERINE D KETTERHAGEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002581

License Status

NOT RENEWED

Business

First Name

KATHERINE

Middle

Last Name

KETTERHAGEN

Business Name

KATHERINE D KETTERHAGEN

Original Issue Date

09/19/2005

Effective Date

02/25/2010

Expiration Date

03/01/2012

City

WALWORTH

State

Zip

53184

County

WISCONSIN

Ever Disciplined

LastModifiedDate

03/13/2013