ELLIOT M SIMON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005322

License Status

NOT RENEWED

Business

First Name

ELLIOT

Middle

Last Name

SIMON

Business Name

ELLIOT M SIMON

Original Issue Date

10/16/2014

Effective Date

10/16/2014

Expiration Date

03/01/2016

City

HARTFORD

State

Zip

53027

County

WISCONSIN

Ever Disciplined

LastModifiedDate

04/25/2016