ALEXANDRA MARIE DEWULF Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006585

License Status

NOT RENEWED

Business

First Name

ALEXANDRA

Middle

MARIE

Last Name

DEWULF

Business Name

ALEXANDRA MARIE DEWULF

Original Issue Date

05/09/2018

Effective Date

05/09/2018

Expiration Date

03/01/2020

City

PHOENIX

State

Zip

85018

County

ARIZONA

Ever Disciplined

LastModifiedDate

11/24/2020