ROBERT J CAPELLO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003171

License Status

NOT RENEWED

Business

First Name

ROBERT

Middle

Last Name

CAPELLO

Business Name

ROBERT J CAPELLO

Original Issue Date

12/19/2007

Effective Date

12/15/2017

Expiration Date

03/01/2020

City

WAVERLY

State

Zip

68462

Ever Disciplined

LastModifiedDate

11/24/2020