CHARLES LEWIS KOCK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004435

License Status

NOT RENEWED

Business

First Name

CHARLES

Middle

LEWIS

Last Name

KOCK

Business Name

CHARLES LEWIS KOCK

Original Issue Date

09/04/2012

Effective Date

09/04/2012

Expiration Date

03/01/2014

City

HOUMA

State

Zip

70360

County

LOUISIANA

Ever Disciplined

LastModifiedDate

04/14/2016