KEIRSTIN A MOTT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****80

License Status

NOT RENEWED

Business

First Name

KEIRSTIN

Middle

Last Name

MOTT

Business Name

KEIRSTIN A MOTT

Original Issue Date

10/20/2010

Effective Date

01/13/2014

Expiration Date

03/01/2016

City

GLEN CARBON

State

Zip

62034

County

MADISON

Ever Disciplined

LastModifiedDate

07/18/2025