SUSAN LEE BOTT - Physician Assistant License in Illinois | # 085000680

SUSAN LEE BOTT

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000680

License Status

NOT RENEWED

Business

N

First Name

SUSAN LEE

Last Name

BOTT

Business Name

SUSAN LEE BOTT

Original Issue Date

03/28/1995

Effective Date

03/28/1995

Expiration Date

03/01/1996

State

IL

Ever Disciplined

N

LastModifiedDate

09/26/2006