MARY L PINE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001068

License Status

NOT RENEWED

Business

First Name

MARY

Middle

Last Name

PINE

Business Name

MARY L PINE

Original Issue Date

07/20/1998

Effective Date

07/20/1998

Expiration Date

03/01/2004

City

METROPOLIS

State

Zip

62960

County

MASSAC

Ever Disciplined

LastModifiedDate

03/18/2026