ELIZABETH A RANDOLPH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004815

License Status

NOT RENEWED

Business

First Name

ELIZABETH

Middle

Last Name

RANDOLPH

Business Name

ELIZABETH A RANDOLPH

Original Issue Date

09/05/2013

Effective Date

03/03/2014

Expiration Date

03/01/2016

City

FENTON

State

Zip

63026

County

MISSOURI

Ever Disciplined

LastModifiedDate

04/25/2016