JILL CHRISTINE DEFAUW Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008000

License Status

ACTIVE

Business

First Name

JILL

Middle

CHRISTINE

Last Name

DEFAUW

Business Name

JILL CHRISTINE DEFAUW

Original Issue Date

10/05/2020

Effective Date

12/06/2023

Expiration Date

03/01/2026

City

CEDARBURG

State

Zip

53012

Ever Disciplined

LastModifiedDate

12/03/2025