MALLORY ELISABETH GAUTHIER Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006422

License Status

ACTIVE

Business

First Name

MALLORY

Middle

ELISABETH

Last Name

GAUTHIER

Business Name

MALLORY ELISABETH GAUTHIER

Original Issue Date

10/25/2017

Effective Date

01/07/2026

Expiration Date

03/01/2028

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

01/07/2026