KEITH DAVID ROULEAU Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002897

License Status

NOT RENEWED

Business

First Name

KEITH

Middle

DAVID

Last Name

ROULEAU

Business Name

KEITH DAVID ROULEAU

Original Issue Date

11/22/2006

Effective Date

02/27/2012

Expiration Date

03/01/2014

City

MURRIETA

State

Zip

92563

Ever Disciplined

LastModifiedDate

03/04/2015