MOLLIE DWIVEDI Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****73

License Status

INOPERATIVE

Business

First Name

MOLLIE

Last Name

DWIVEDI

Business Name

MOLLIE DWIVEDI

Original Issue Date

02/25/2019

Effective Date

12/18/2019

Expiration Date

03/01/2022

City

SAINT LOUIS

State

Zip

63130

Ever Disciplined

LastModifiedDate

01/03/2022