NINA MARIA CHACKO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007162

License Status

NOT RENEWED

Business

First Name

NINA

Middle

MARIA

Last Name

CHACKO

Business Name

NINA MARIA CHACKO

Original Issue Date

08/10/2019

Effective Date

01/15/2020

Expiration Date

03/01/2022

City

OCEAN

State

Zip

07712

County

TENNESSEE

Ever Disciplined

LastModifiedDate

07/27/2022