MATTHEW J MARTIN Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****63

License Status

INOPERATIVE

Business

First Name

MATTHEW

Middle

Last Name

MARTIN

Business Name

MATTHEW J MARTIN

Original Issue Date

09/01/2005

Effective Date

01/29/2014

Expiration Date

03/01/2016

City

CHICAGO

State

Zip

60631

County

COOK

Ever Disciplined

LastModifiedDate

10/15/2015