RICHARD AUSTIN HAZLETT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006979

License Status

NOT RENEWED

Business

First Name

RICHARD

Middle

AUSTIN

Last Name

HAZLETT

Business Name

RICHARD AUSTIN HAZLETT

Original Issue Date

03/13/2019

Effective Date

10/01/2020

Expiration Date

03/01/2022

City

SAINT LOUIS

State

Zip

63116

Ever Disciplined

LastModifiedDate

07/27/2022