ELLIS JON THOMPSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005198

License Status

NOT RENEWED

Business

First Name

ELLIS

Middle

JON

Last Name

THOMPSON

Business Name

ELLIS JON THOMPSON

Original Issue Date

09/04/2014

Effective Date

02/22/2018

Expiration Date

03/01/2020

City

LOUISVILLE

State

Zip

40205

County

JEFFERSON

Ever Disciplined

LastModifiedDate

11/24/2020