License holder summary

TAEJA MAE BROADWATER is a Temporary Physician Assistant licensed to practice in Pennsylvania. The address on file for TAEJA MAE BROADWATER is Bloomsburg PA 17815. This licensed professional license is not current. The license was granted 08/03/2012 and expired on 08/03/2013.

Pennsylvania

Department of State

TAEJA MAE BROADWATER
Temporary Physician Assistant
License number
TMA052673
Date granted
08/03/2012
Date expires
08/03/2013
Class
Temporary Physician Assistant
Status
Voided
Address
Bloomsburg PA 17815
palicensing.org
ID 16655591
LAST UPDATED 2024-03-10 16:10:58 UTC

This website is unaffiliated with the Department of State. Please verify all information directly with the relevant official government authority.

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