KIRSTEN J ANTONNEAU Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004110

License Status

NOT RENEWED

Business

First Name

KIRSTEN

Middle

Last Name

ANTONNEAU

Business Name

KIRSTEN J ANTONNEAU

Original Issue Date

08/24/2011

Effective Date

08/24/2011

Expiration Date

03/01/2012

City

MOUNT PLEASANT

State

Zip

53405

County

WISCONSIN

Ever Disciplined

LastModifiedDate

04/11/2012