CHARLES ALLEN MASON MD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000613

License Status

NOT RENEWED

Business

Title

First Name

CHARLES

Middle

ALLEN

Last Name

MASON

Business Name

CHARLES ALLEN MASON MD

Original Issue Date

06/01/1994

Effective Date

06/01/1994

Expiration Date

03/01/1996

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

09/26/2006