CAROLYN M BOOTH Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000426

License Status

INACTIVE

Business

First Name

CAROLYN M

Last Name

BOOTH

Business Name

CAROLYN M BOOTH

Original Issue Date

10/30/1990

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

SAINT LOUIS

State

Zip

63121

Ever Disciplined

LastModifiedDate

09/22/2010