MICHAEL J GIBSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****12

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

GIBSON

Business Name

MICHAEL J GIBSON

Original Issue Date

01/24/2001

Effective Date

01/24/2001

Expiration Date

03/01/2006

City

MANITO

State

Zip

61546

County

MASON

Ever Disciplined

LastModifiedDate

10/09/2006