KENNETH R ELLISON
Physician Assistant at Mar Walt Dr, Fort Walton Beach, FL

License number
Florida 9106823
Issued Date
Sep 12, 2012
Effective Date
Sep 12, 2012
Expiration Date
Jan 31, 2018
Category
Health Care
Type
Physician Assistant
Address
Address
1032 Mar Walt Dr SUITE 250, Fort Walton Beach, FL 32547
Phone
(850) 863-3463
LicenseFiles verified this license of Jun 1, 2017 at the Health Care Practitioner Data Portal.

Personal information

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Name
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4868 Huffy Ct, Lake Wales, FL 33859
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