MALLORY ELISABETH GAUTHIER Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****35

License Status

ACTIVE

Business

First Name

MALLORY

Middle

ELISABETH

Last Name

GAUTHIER

Business Name

MALLORY ELISABETH GAUTHIER

Original Issue Date

11/30/2017

Effective Date

01/07/2026

Expiration Date

03/01/2028

City

CARBONDALE

State

Zip

62901

County

JACKSON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/07/2026