RUSSELL JOHN KINSEY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****67

License Status

NOT RENEWED

Business

First Name

RUSSELL

Middle

JOHN

Last Name

KINSEY

Business Name

RUSSELL JOHN KINSEY

Original Issue Date

06/04/2013

Effective Date

02/18/2022

Expiration Date

03/01/2024

City

WASHINGTON

State

Zip

63090

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025