AUTUMN KRYSTAL VALK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003712

License Status

NOT RENEWED

Business

First Name

AUTUMN

Middle

KRYSTAL

Last Name

VALK

Business Name

AUTUMN KRYSTAL VALK

Original Issue Date

03/31/2010

Effective Date

02/25/2016

Expiration Date

03/01/2018

City

APPLETON

State

Zip

54915

County

WISCONSIN

Ever Disciplined

LastModifiedDate

05/10/2018