RUBYE BARDOUILLE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007463

License Status

NOT RENEWED

Business

First Name

RUBYE

Last Name

BARDOUILLE

Business Name

RUBYE BARDOUILLE

Original Issue Date

12/10/2019

Effective Date

12/10/2019

Expiration Date

03/01/2022

City

CLARKSVILLE

State

Zip

37042

Ever Disciplined

LastModifiedDate

07/27/2022