The holder whose full name is Beaty, Marisa B.,come from Indianapolis IN,hold the Physician Assistant - Prescriptive Authority license(NO.10001679A) which status is Active.
| Name | Beaty, Marisa B. |
|---|---|
| License Number | 10001679A |
| License Type | Physician Assistant - Prescriptive Authority |
| License Status | Active |
| City | Indianapolis |
| State | IN |