MARTIN N KATAMBWA Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****53

License Status

NOT RENEWED

Business

First Name

MARTIN

Middle

Last Name

KATAMBWA

Business Name

MARTIN N KATAMBWA

Original Issue Date

08/28/2013

Effective Date

03/03/2016

Expiration Date

03/01/2018

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

05/10/2018