KATHLEEN J KEITHLEY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002555

License Status

NOT RENEWED

Business

First Name

KATHLEEN

Middle

Last Name

KEITHLEY

Business Name

KATHLEEN J KEITHLEY

Original Issue Date

09/02/2005

Effective Date

09/02/2005

Expiration Date

03/01/2008

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

04/23/2008