KAYLA RENE VANDERWALL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007328

License Status

NOT RENEWED

Business

First Name

KAYLA

Middle

RENE

Last Name

VANDERWALL

Business Name

KAYLA RENE VANDERWALL

Original Issue Date

10/01/2019

Effective Date

01/21/2022

Expiration Date

03/01/2024

City

INDIANAPOLIS

State

Zip

46220

Ever Disciplined

LastModifiedDate

02/05/2025