JOHN ROBERT LARSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007873

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

ROBERT

Last Name

LARSON

Business Name

JOHN ROBERT LARSON

Original Issue Date

08/06/2020

Effective Date

01/14/2022

Expiration Date

03/01/2024

City

WALL TOWNSHIP

State

Zip

07719

Ever Disciplined

LastModifiedDate

02/05/2025