MELANIE ROSE DART Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004300

License Status

NOT RENEWED

Business

First Name

MELANIE

Middle

ROSE

Last Name

DART

Business Name

MELANIE ROSE DART

Original Issue Date

03/26/2012

Effective Date

03/26/2012

Expiration Date

03/01/2014

City

GREEN BAY

State

Zip

54311

County

WISCONSIN

Ever Disciplined

LastModifiedDate

04/08/2014