PHILLIP A DEWEY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005463

License Status

NOT RENEWED

Business

First Name

PHILLIP

Middle

Last Name

DEWEY

Business Name

PHILLIP A DEWEY

Original Issue Date

05/01/2015

Effective Date

02/08/2022

Expiration Date

03/01/2024

City

CARTERVILLE

State

Zip

62918

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

02/05/2025