KELLEY A KRUG Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****51

License Status

NOT RENEWED

Business

First Name

KELLEY

Middle

Last Name

KRUG

Business Name

KELLEY A KRUG

Original Issue Date

03/22/2001

Effective Date

01/04/2022

Expiration Date

03/01/2024

City

KNOXVILLE

State

Zip

61448

County

KNOX

Ever Disciplined

LastModifiedDate

02/05/2025