CHARLES DAVID GAUTHIER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****38

License Status

NOT RENEWED

Business

First Name

CHARLES

Middle

DAVID

Last Name

GAUTHIER

Business Name

CHARLES DAVID GAUTHIER

Original Issue Date

01/21/2004

Effective Date

01/21/2004

Expiration Date

03/01/2006

City

ROBINSON

State

Zip

62454

County

CRAWFORD

Ever Disciplined

LastModifiedDate

09/26/2006