ANNALYSE BUCHOLTZ Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003796

License Status

INACTIVE

Business

First Name

ANNALYSE

Last Name

BUCHOLTZ

Business Name

ANNALYSE BUCHOLTZ

Original Issue Date

07/15/2010

Effective Date

02/05/2020

Expiration Date

03/01/2022

City

PEWAUKEE

State

Zip

53072

County

WISCONSIN

Ever Disciplined

LastModifiedDate

02/28/2022