AMBER L KELLEY Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****86

License Status

INOPERATIVE

Business

First Name

AMBER

Middle

Last Name

KELLEY

Business Name

AMBER L KELLEY

Original Issue Date

06/22/2009

Effective Date

01/12/2012

Expiration Date

03/01/2014

City

DECATUR

State

Zip

62526

County

MACON

Ever Disciplined

LastModifiedDate

08/01/2012