ROBERT J MONTGOMERY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****47

License Status

NOT RENEWED

Business

First Name

ROBERT

Middle

Last Name

MONTGOMERY

Business Name

ROBERT J MONTGOMERY

Original Issue Date

08/23/2018

Effective Date

02/26/2020

Expiration Date

03/01/2022

City

NEW HAVEN

State

Zip

63068

County

MADISON

Ever Disciplined

LastModifiedDate

07/27/2022