JUSTIN ZACHARY MARTINEZ Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004484

License Status

NOT RENEWED

Business

First Name

JUSTIN

Middle

ZACHARY

Last Name

MARTINEZ

Business Name

JUSTIN ZACHARY MARTINEZ

Original Issue Date

10/03/2012

Effective Date

10/03/2012

Expiration Date

03/01/2014

City

CHICAGO

State

Zip

60640

County

COOK

Ever Disciplined

LastModifiedDate

04/08/2014