AUSTIN MICHAEL SOUTHMAYD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085009300

License Status

NOT RENEWED

Business

First Name

AUSTIN

Middle

MICHAEL

Last Name

SOUTHMAYD

Business Name

AUSTIN MICHAEL SOUTHMAYD

Original Issue Date

10/22/2022

Effective Date

10/22/2022

Expiration Date

03/01/2024

City

SAINT PETERS

State

Zip

63304

Ever Disciplined

LastModifiedDate

02/05/2025