The holder whose full name is Martin, Charles Kevin,come from Fort Wayne IN,hold the Physician Assistant - Prescriptive Authority license(NO.10000978A) which status is Expired.
| Name | Martin, Charles Kevin |
|---|---|
| License Number | 10000978A |
| License Type | Physician Assistant - Prescriptive Authority |
| License Status | Expired |
| City | Fort Wayne |
| State | IN |