GUOQING SONG Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005846

License Status

NOT RENEWED

Business

First Name

GUOQING

Last Name

SONG

Business Name

GUOQING SONG

Original Issue Date

06/23/2016

Effective Date

06/23/2016

Expiration Date

03/01/2018

City

MADISON

State

Zip

53705

County

WISCONSIN

Ever Disciplined

LastModifiedDate

05/10/2018