GARY J FISK Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000405

License Status

INACTIVE

Business

First Name

GARY

Middle

Last Name

FISK

Business Name

GARY J FISK

Original Issue Date

05/12/1990

Effective Date

02/24/2014

Expiration Date

03/01/2016

City

MORTON

State

Zip

61550

County

TAZEWELL

Ever Disciplined

LastModifiedDate

03/29/2016