NATHALIE ANNE GALLO Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002676

License Status

INACTIVE

Business

First Name

NATHALIE

Middle

ANNE

Last Name

GALLO

Business Name

NATHALIE ANNE GALLO

Original Issue Date

12/21/2005

Effective Date

12/21/2005

Expiration Date

03/01/2008

City

RACINE

State

Zip

53406

Ever Disciplined

LastModifiedDate

12/14/2007