RICKY A POWELL Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****39

License Status

INOPERATIVE

Business

First Name

RICKY

Middle

Last Name

POWELL

Business Name

RICKY A POWELL

Original Issue Date

05/25/2010

Effective Date

02/06/2012

Expiration Date

03/01/2014

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

07/12/2012