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Kaela
Kaela
Bacon
Physician assistant
Wesley Chapel, United States
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Florida Health Care Practitioner Data Portal
Full name
Kaela Bacon
Job Title
Physician Assistant
Location
Wesley Chapel, FL, USA
LIC ID
14102
Current License Expiration Date
31/01/2026
Original Date
26/09/2017
Professional Rank Code
PA
Effective Date
26/09/2017
Board Action Indicator
N
License Status Description
CLEAR
License Active Status Description
ACTIVE
Country Description
PASCO
Practice Location Address Line 1
2352 Bruce B Downs Blvd
Practice Location Address Line 2
Suite 101
Practice Location Address City
WESLEY CHAPEL
Practice Location Address State
FL
Practice Location Address Zipcode
33544
Mode Code
Prescribing
Prescribing Indicator
N
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