CARLOS D LOPEZ Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004386

License Status

NOT RENEWED

Business

First Name

CARLOS

Middle

Last Name

LOPEZ

Business Name

CARLOS D LOPEZ

Original Issue Date

08/06/2012

Effective Date

08/06/2012

Expiration Date

03/01/2014

City

MARTINEZ

State

Zip

30907

County

GEORGIA

Ever Disciplined

LastModifiedDate

04/08/2014