MARTIN MEDINA Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****69

License Status

INOPERATIVE

Business

First Name

MARTIN

Last Name

MEDINA

Business Name

MARTIN MEDINA

Original Issue Date

09/27/2023

Effective Date

01/18/2024

Expiration Date

03/01/2026

City

ZION

State

Zip

60099

Ever Disciplined

LastModifiedDate

12/03/2025