BETHANY AGRICOLA SLY Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085009749

License Status

ACTIVE

Business

First Name

BETHANY

Middle

AGRICOLA

Last Name

SLY

Business Name

BETHANY AGRICOLA SLY

Original Issue Date

07/01/2023

Effective Date

02/02/2026

Expiration Date

03/01/2028

City

MARCELLUS

State

Zip

13108

Ever Disciplined

LastModifiedDate

02/02/2026