CHARLES M PIMENTEL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****49

License Status

NOT RENEWED

Business

First Name

CHARLES M

Last Name

PIMENTEL

Business Name

CHARLES M PIMENTEL

Original Issue Date

03/27/2001

Effective Date

03/27/2001

Expiration Date

03/01/2004

City

LITCHFIELD

State

Zip

62056

County

MACOUPIN

Ever Disciplined

LastModifiedDate

10/09/2006