IAN WETHERALL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007616

License Status

NOT RENEWED

Business

First Name

IAN

Last Name

WETHERALL

Business Name

IAN WETHERALL

Original Issue Date

03/24/2020

Effective Date

03/24/2020

Expiration Date

03/01/2022

City

SAINT PETERSBURG

State

Zip

33713

Ever Disciplined

LastModifiedDate

07/27/2022