KELLY M STANIS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000883

License Status

NOT RENEWED

Business

First Name

KELLY M

Last Name

STANIS

Business Name

KELLY M STANIS

Original Issue Date

01/30/1997

Effective Date

01/30/1997

Expiration Date

03/01/1998

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

09/26/2006