KALLIE BASHOR Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008404

License Status

NOT RENEWED

Business

First Name

KALLIE

Last Name

BASHOR

Business Name

KALLIE BASHOR

Original Issue Date

06/25/2021

Effective Date

06/25/2021

Expiration Date

03/01/2022

City

BETTENDORF

State

Zip

52722

Ever Disciplined

LastModifiedDate

07/27/2022