MADISON LANE WELLEN Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085011968

License Status

ACTIVE

Business

First Name

MADISON

Middle

LANE

Last Name

WELLEN

Business Name

MADISON LANE WELLEN

Original Issue Date

12/18/2025

Effective Date

12/18/2025

Expiration Date

03/01/2028

City

SAINT LOUIS

State

Zip

63110

Ever Disciplined

LastModifiedDate

12/18/2025