JOSELITO E GANNABAN JR MD - Physician Assistant License in Illinois | # 085000033

JOSELITO E GANNABAN JR MD

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000033

License Status

NOT RENEWED

Business

N

First Name

JOSELITO

Middle

E

Last Name

GANNABAN

Suffix

JR MD

Business Name

JOSELITO E GANNABAN JR MD

Original Issue Date

11/15/1980

Effective Date

11/15/1980

Expiration Date

03/01/1996

State

IL

Ever Disciplined

N

LastModifiedDate

11/27/2017