KELLY KENNETH AMBROSIUS Surgical Assistant/Technologist License verification

Business Entity

NOT RENEWED

License Type

Surgical Assistant/Technologist

Description

REGISTERED SURGICAL ASSISTANT

License Number

238000009

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

KENNETH

Last Name

AMBROSIUS

Business Name

KELLY KENNETH AMBROSIUS

Original Issue Date

08/19/2005

Effective Date

04/06/2020

Expiration Date

05/31/2022

City

KENOSHA

State

Zip

53142

County

LAKE

Ever Disciplined

LastModifiedDate

07/27/2022