MARY L BRANDENBURG - Physician Assistant License in Illinois | # 085001021

MARY L BRANDENBURG

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001021

License Status

NOT RENEWED

Business

N

First Name

MARY

Middle

L

Last Name

BRANDENBURG

Business Name

MARY L BRANDENBURG

Original Issue Date

01/30/1998

Effective Date

07/06/2018

Expiration Date

03/01/2020

State

IL

Ever Disciplined

N

LastModifiedDate

11/24/2020