AMANDA JEAN NEILS Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004198

License Status

INACTIVE

Business

First Name

AMANDA

Middle

JEAN

Last Name

NEILS

Business Name

AMANDA JEAN NEILS

Original Issue Date

10/12/2011

Effective Date

10/12/2011

Expiration Date

03/01/2012

City

ELKHART LAKE

State

Zip

53020

County

WISCONSIN

Ever Disciplined

LastModifiedDate

12/07/2011