ALEXANDRA T POWELL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****69

License Status

NOT RENEWED

Business

First Name

ALEXANDRA

Middle

Last Name

POWELL

Business Name

ALEXANDRA T POWELL

Original Issue Date

12/22/2017

Effective Date

01/07/2020

Expiration Date

03/01/2022

City

CARBONDALE

State

Zip

62901

County

JACKSON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022