ANTONIA M DECKER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005534

License Status

NOT RENEWED

Business

First Name

ANTONIA

Middle

Last Name

DECKER

Business Name

ANTONIA M DECKER

Original Issue Date

07/08/2015

Effective Date

03/09/2018

Expiration Date

03/01/2020

City

LAKE GENEVA

State

Zip

53147

Ever Disciplined

LastModifiedDate

11/24/2020