BLAIR ANTHONY MALENCH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004418

License Status

NOT RENEWED

Business

First Name

BLAIR

Middle

ANTHONY

Last Name

MALENCH

Business Name

BLAIR ANTHONY MALENCH

Original Issue Date

08/21/2012

Effective Date

01/15/2022

Expiration Date

03/01/2024

City

SAINT LOUIS

State

Zip

63122

Ever Disciplined

LastModifiedDate

02/05/2025