ANGELA MARIE CLARK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008289

License Status

NOT RENEWED

Business

First Name

ANGELA

Middle

MARIE

Last Name

CLARK

Business Name

ANGELA MARIE CLARK

Original Issue Date

04/26/2021

Effective Date

02/03/2022

Expiration Date

03/01/2024

City

NEW GLARUS

State

Zip

53574

Ever Disciplined

LastModifiedDate

02/05/2025