CHARLES A BURKOWSKI Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****01

License Status

NOT RENEWED

Business

First Name

CHARLES

Middle

Last Name

BURKOWSKI

Business Name

CHARLES A BURKOWSKI

Original Issue Date

05/18/2001

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

DANVILLE

State

Zip

61832

County

VERMILION

Ever Disciplined

LastModifiedDate

02/10/2011