MARY ELIZABETH KING JOHNSON Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003419

License Status

INACTIVE

Business

First Name

MARY

Middle

ELIZABETH KING

Last Name

JOHNSON

Business Name

MARY ELIZABETH KING JOHNSON

Original Issue Date

01/29/2009

Effective Date

03/18/2010

Expiration Date

03/01/2012

City

BALLWIN

State

Zip

63021

County

MISSOURI

Ever Disciplined

LastModifiedDate

01/12/2012