SCOTT ANDREW KLASSEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****67

License Status

NOT RENEWED

Business

First Name

SCOTT

Middle

ANDREW

Last Name

KLASSEN

Business Name

SCOTT ANDREW KLASSEN

Original Issue Date

08/13/2015

Effective Date

02/23/2018

Expiration Date

03/01/2020

City

WATERLOO

State

Zip

62298

County

MONROE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020