STEVEN LAWRENCE MARTIN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002597

License Status

NOT RENEWED

Business

First Name

STEVEN

Middle

LAWRENCE

Last Name

MARTIN

Business Name

STEVEN LAWRENCE MARTIN

Original Issue Date

09/28/2005

Effective Date

03/03/2020

Expiration Date

03/01/2022

City

CHARLESTON

State

Zip

61920

County

COLES

Ever Disciplined

LastModifiedDate

07/27/2022