IRAKLI SHENGELIA Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003990

License Status

INACTIVE

Business

First Name

IRAKLI

Last Name

SHENGELIA

Business Name

IRAKLI SHENGELIA

Original Issue Date

02/08/2011

Effective Date

02/26/2014

Expiration Date

03/01/2016

City

KIRKWOOD

State

Zip

63122

County

MISSOURI

Ever Disciplined

LastModifiedDate

01/21/2016