ELEN SHELLEY PUCKETT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006289

License Status

NOT RENEWED

Business

First Name

ELEN

Middle

SHELLEY

Last Name

PUCKETT

Business Name

ELEN SHELLEY PUCKETT

Original Issue Date

08/03/2017

Effective Date

08/03/2017

Expiration Date

03/01/2018

City

NASHVILLE

State

Zip

37214

County

TENNESSEE

Ever Disciplined

LastModifiedDate

05/10/2018