CHARLOTTE MARIE CRISMYRE Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****58

License Status

INOPERATIVE

Business

First Name

CHARLOTTE

Middle

MARIE

Last Name

CRISMYRE

Business Name

CHARLOTTE MARIE CRISMYRE

Original Issue Date

08/22/2011

Effective Date

02/24/2014

Expiration Date

03/01/2016

City

EFFINGHAM

State

Zip

62401

County

EFFINGHAM

Ever Disciplined

LastModifiedDate

02/24/2014