CHARLES LEWIS KOCK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****93

License Status

NOT RENEWED

Business

First Name

CHARLES

Middle

LEWIS

Last Name

KOCK

Business Name

CHARLES LEWIS KOCK

Original Issue Date

09/26/2012

Effective Date

09/26/2012

Expiration Date

03/01/2014

State

Ever Disciplined

LastModifiedDate

04/14/2016