WEIZHONG SONG Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005637

License Status

NOT RENEWED

Business

First Name

WEIZHONG

Last Name

SONG

Business Name

WEIZHONG SONG

Original Issue Date

09/17/2015

Effective Date

02/18/2016

Expiration Date

03/01/2018

City

NEW BERLIN

State

Zip

53151

Ever Disciplined

LastModifiedDate

05/10/2018