KATHLEEN J KEITHLEY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****94

License Status

NOT RENEWED

Business

First Name

KATHLEEN

Middle

Last Name

KEITHLEY

Business Name

KATHLEEN J KEITHLEY

Original Issue Date

10/05/2005

Effective Date

10/05/2005

Expiration Date

03/01/2008

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

11/13/2007