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Moline
Moline
Blanc
Physician assistant
Owner
Ormond Beach, United States
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Reveal information
Florida Health Care Practitioner Data Portal
Full name
MOLINE BLANC
Job Title
Physician Assistant
Location
Ormond Beach, FL, USA
LIC ID
12004
Current License Expiration Date
31/01/2026
Original Date
27/07/2015
Professional Rank Code
PA
Effective Date
27/07/2015
Board Action Indicator
N
License Status Description
CLEAR
License Active Status Description
ACTIVE
Country Description
VOLUSIA
Mailing Address Line 2
Unit 430
Practice Location Address Line 1
325 Clyde Morris Blvd
Practice Location Address Line 2
Unit 430
Practice Location Address City
ORMOND BEACH
Practice Location Address State
FL
Practice Location Address Zipcode
32174
Mode Code
Prescribing
Prescribing Indicator
N
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