ANDREA KATHRYN STOUT Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004179

License Status

ACTIVE

Business

First Name

ANDREA

Middle

KATHRYN

Last Name

STOUT

Business Name

ANDREA KATHRYN STOUT

Original Issue Date

10/03/2011

Effective Date

12/03/2025

Expiration Date

03/01/2028

City

COLUMBIA

State

Zip

62236

County

MONROE

Ever Disciplined

LastModifiedDate

12/03/2025