AMANDA COCHRAN LANGE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004518

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

COCHRAN

Last Name

LANGE

Business Name

AMANDA COCHRAN LANGE

Original Issue Date

10/22/2012

Effective Date

01/14/2020

Expiration Date

03/01/2022

City

EAU CLAIRE

State

Zip

54701

Ever Disciplined

LastModifiedDate

07/27/2022