BONNIE OTTO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007784

License Status

NOT RENEWED

Business

First Name

BONNIE

Last Name

OTTO

Business Name

BONNIE OTTO

Original Issue Date

06/24/2020

Effective Date

06/24/2020

Expiration Date

03/01/2022

City

CHESTERFIELD

State

Zip

63017

Ever Disciplined

LastModifiedDate

07/27/2022