ELEANOR THEOBALD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008277

License Status

NOT RENEWED

Business

First Name

ELEANOR

Last Name

THEOBALD

Business Name

ELEANOR THEOBALD

Original Issue Date

04/12/2021

Effective Date

01/15/2022

Expiration Date

03/01/2024

City

FT LAUDERDALE

State

Zip

33304

Ever Disciplined

LastModifiedDate

02/05/2025