MELISSA MARGARET CROCKER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007351

License Status

NOT RENEWED

Business

First Name

MELISSA

Middle

MARGARET

Last Name

CROCKER

Business Name

MELISSA MARGARET CROCKER

Original Issue Date

10/08/2019

Effective Date

02/18/2020

Expiration Date

03/01/2022

City

SAINT LOUIS

State

Zip

63110

Ever Disciplined

LastModifiedDate

07/27/2022