MARTA TABAKA Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002960

License Status

NOT RENEWED

Business

First Name

MARTA

Last Name

TABAKA

Business Name

MARTA TABAKA

Original Issue Date

04/30/2007

Effective Date

05/06/2008

Expiration Date

03/01/2010

City

WAIPAHU

State

Zip

96797

Ever Disciplined

LastModifiedDate

04/01/2010