STEVEN LAWRENCE MARTIN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****52

License Status

NOT RENEWED

Business

First Name

STEVEN

Middle

LAWRENCE

Last Name

MARTIN

Business Name

STEVEN LAWRENCE MARTIN

Original Issue Date

12/12/2005

Effective Date

03/03/2020

Expiration Date

03/01/2022

City

CHARLESTON

State

Zip

61920

County

EDGAR

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022