TEAL MARIE PECK Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000811

License Status

INACTIVE

Business

First Name

TEAL MARIE

Last Name

PECK

Business Name

TEAL MARIE PECK

Original Issue Date

07/19/1996

Effective Date

07/19/1996

Expiration Date

03/01/2000

City

ALBUQUERQUE

State

Zip

87114

County

NEW MEXICO

Ever Disciplined

LastModifiedDate

09/26/2006