Wisconsin
Department of Safety and Professional Services
Black, Jennifer L
Physician Assistant
License number
1910-23
Date granted
08/04/2005
Date expires
02/28/2014
Class
Physician Assistant
Status
Active
wisconsinlicensing.org
ID 12800364
LAST UPDATED 2024-02-19 14:55:19 UTC
LAST UPDATED 2024-02-19 14:55:19 UTC
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