MEGAN NICOLE BRECKENKAMP Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008590

License Status

NOT RENEWED

Business

First Name

MEGAN

Middle

NICOLE

Last Name

BRECKENKAMP

Business Name

MEGAN NICOLE BRECKENKAMP

Original Issue Date

09/03/2021

Effective Date

01/05/2022

Expiration Date

03/01/2024

City

SAINT LOUIS

State

Zip

63108

Ever Disciplined

LastModifiedDate

02/05/2025