PATRICIA A BOUDET Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****00

License Status

NOT RENEWED

Business

First Name

PATRICIA

Middle

Last Name

BOUDET

Business Name

PATRICIA A BOUDET

Original Issue Date

05/18/2001

Effective Date

10/14/2021

Expiration Date

03/01/2022

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

07/27/2022