MOLLIE DWIVEDI - Physician Assistant License in Missouri | # 38*****73

MOLLIE DWIVEDI

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****73

License Status

INOPERATIVE

Business

N

First Name

MOLLIE

Last Name

DWIVEDI

Business Name

MOLLIE DWIVEDI

Original Issue Date

02/25/2019

Effective Date

12/18/2019

Expiration Date

03/01/2022

State

MO

Ever Disciplined

N

LastModifiedDate

01/03/2022