TODD ANDREW BOUTON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008693

License Status

NOT RENEWED

Business

First Name

TODD

Middle

ANDREW

Last Name

BOUTON

Business Name

TODD ANDREW BOUTON

Original Issue Date

10/13/2021

Effective Date

10/13/2021

Expiration Date

03/01/2022

City

FRANKLIN

State

Zip

53132

Ever Disciplined

LastModifiedDate

07/27/2022