DERRICK H CRASS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****78

License Status

NOT RENEWED

Business

First Name

DERRICK H

Last Name

CRASS

Business Name

DERRICK H CRASS

Original Issue Date

01/08/2015

Effective Date

02/26/2018

Expiration Date

03/01/2020

City

SAINT LOUIS

State

Zip

63116

County

SAINT CLAIR

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020