ZACHARY ADAM LINES Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005161

License Status

NOT RENEWED

Business

First Name

ZACHARY

Middle

ADAM

Last Name

LINES

Business Name

ZACHARY ADAM LINES

Original Issue Date

08/20/2014

Effective Date

02/23/2018

Expiration Date

03/01/2020

City

BLACK EARTH

State

Zip

53515

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/24/2020