VALERIE ANASTASIA CARROLL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003005

License Status

NOT RENEWED

Business

First Name

VALERIE

Middle

ANASTASIA

Last Name

CARROLL

Business Name

VALERIE ANASTASIA CARROLL

Original Issue Date

07/23/2007

Effective Date

01/10/2012

Expiration Date

03/01/2014

City

MADISON

State

Zip

53703

County

WISCONSIN

Ever Disciplined

LastModifiedDate

04/08/2014