REBECCA DANIELLE BLAKKOLB Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004703

License Status

ACTIVE

Business

First Name

REBECCA

Middle

DANIELLE

Last Name

BLAKKOLB

Business Name

REBECCA DANIELLE BLAKKOLB

Original Issue Date

07/05/2013

Effective Date

02/22/2024

Expiration Date

03/01/2026

City

KATY

State

Zip

77493

Ever Disciplined

LastModifiedDate

12/03/2025