KACIE HOLMAN SMITH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004355

License Status

NOT RENEWED

Business

First Name

KACIE

Middle

HOLMAN

Last Name

SMITH

Business Name

KACIE HOLMAN SMITH

Original Issue Date

07/17/2012

Effective Date

07/17/2012

Expiration Date

03/01/2014

City

MILWAUKEE

State

Zip

53202

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/07/2014