KAREN DYER BLACKWELL Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****65

License Status

INOPERATIVE

Business

First Name

KAREN

Middle

DYER

Last Name

BLACKWELL

Business Name

KAREN DYER BLACKWELL

Original Issue Date

02/04/2016

Effective Date

02/04/2016

Expiration Date

03/01/2018

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

05/02/2018