CHARLES A BURKOWSKI Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001569

License Status

INACTIVE

Business

First Name

CHARLES

Middle

Last Name

BURKOWSKI

Business Name

CHARLES A BURKOWSKI

Original Issue Date

03/26/2001

Effective Date

02/11/2010

Expiration Date

03/01/2012

City

DANVILLE

State

Zip

61832

County

VERMILION

Ever Disciplined

LastModifiedDate

01/18/2012