KELLEY DUFOUR Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007877

License Status

NOT RENEWED

Business

First Name

KELLEY

Last Name

DUFOUR

Business Name

KELLEY DUFOUR

Original Issue Date

08/12/2020

Effective Date

08/12/2020

Expiration Date

03/01/2022

City

SAINT LOUIS

State

Zip

63109

Ever Disciplined

LastModifiedDate

07/27/2022