CALLY M GORES-TODD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004594

License Status

NOT RENEWED

Business

First Name

CALLY

Middle

Last Name

GORES-TODD

Business Name

CALLY M GORES-TODD

Original Issue Date

01/03/2013

Effective Date

01/03/2013

Expiration Date

03/01/2014

City

MILWAUKEE

State

Zip

53207

County

WISCONSIN

Ever Disciplined

LastModifiedDate

04/08/2014