MARK JAKUBISIN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007091

License Status

NOT RENEWED

Business

First Name

MARK

Last Name

JAKUBISIN

Business Name

MARK JAKUBISIN

Original Issue Date

06/26/2019

Effective Date

06/26/2019

Expiration Date

03/01/2020

City

CHARLOTTE

State

Zip

28269

Ever Disciplined

LastModifiedDate

11/24/2020