KELLY DAWN BLISS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003451

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

DAWN

Last Name

BLISS

Business Name

KELLY DAWN BLISS

Original Issue Date

04/13/2009

Effective Date

04/04/2018

Expiration Date

03/01/2020

City

SAINT LOUIS

State

Zip

63127

Ever Disciplined

LastModifiedDate

11/24/2020