DENNIS GLENN HAFFORD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007469

License Status

NOT RENEWED

Business

First Name

DENNIS

Middle

GLENN

Last Name

HAFFORD

Business Name

DENNIS GLENN HAFFORD

Original Issue Date

12/26/2019

Effective Date

01/11/2022

Expiration Date

03/01/2024

City

ST. LOUIS

State

Zip

63118

Ever Disciplined

LastModifiedDate

02/05/2025