PHILLIP A DEWEY Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****36

License Status

INOPERATIVE

Business

First Name

PHILLIP

Middle

Last Name

DEWEY

Business Name

PHILLIP A DEWEY

Original Issue Date

09/29/2015

Effective Date

02/08/2022

Expiration Date

03/01/2024

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

12/06/2023