MOLLY KAY RICHTER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****36

License Status

NOT RENEWED

Business

First Name

MOLLY

Middle

KAY

Last Name

RICHTER

Business Name

MOLLY KAY RICHTER

Original Issue Date

03/30/2018

Effective Date

01/23/2020

Expiration Date

03/01/2022

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022