CARLY DIANE WALKER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008331

License Status

NOT RENEWED

Business

First Name

CARLY

Middle

DIANE

Last Name

WALKER

Business Name

CARLY DIANE WALKER

Original Issue Date

06/03/2021

Effective Date

06/03/2021

Expiration Date

03/01/2022

City

ELLISVILLE

State

Zip

63011

Ever Disciplined

LastModifiedDate

07/27/2022