MARTIN N KATAMBWA Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004591

License Status

NOT RENEWED

Business

First Name

MARTIN

Middle

Last Name

KATAMBWA

Business Name

MARTIN N KATAMBWA

Original Issue Date

12/21/2012

Effective Date

03/02/2016

Expiration Date

03/01/2018

City

SAINT LOUIS

State

Zip

63146

Ever Disciplined

LastModifiedDate

05/10/2018