KATHLEEN DUNLEVY ELLIS Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085010816

License Status

ACTIVE

Business

First Name

KATHLEEN

Middle

DUNLEVY

Last Name

ELLIS

Business Name

KATHLEEN DUNLEVY ELLIS

Original Issue Date

09/20/2024

Effective Date

09/20/2024

Expiration Date

03/01/2026

City

MISHAWAKA

State

Zip

46545

Ever Disciplined

LastModifiedDate

12/03/2025