MELISSA LYNNE PORTELL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004999

License Status

NOT RENEWED

Business

First Name

MELISSA

Middle

LYNNE

Last Name

PORTELL

Business Name

MELISSA LYNNE PORTELL

Original Issue Date

03/11/2014

Effective Date

01/05/2021

Expiration Date

03/01/2022

City

SAINT LOUIS

State

Zip

63116

Ever Disciplined

LastModifiedDate

07/27/2022