MALLORY LANE HENRY - Physician Assistant License in Missouri | # 085008076

MALLORY LANE HENRY

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008076

License Status

ACTIVE

Business

N

First Name

MALLORY

Middle

LANE

Last Name

HENRY

Business Name

MALLORY LANE HENRY

Original Issue Date

11/09/2020

Effective Date

12/03/2025

Expiration Date

03/01/2028

State

MO

Ever Disciplined

N

LastModifiedDate

12/03/2025