MICHAEL ROBERT DEPEW PA-C - Physician Assistant License in Illinois | # 085001266

MICHAEL ROBERT DEPEW PA-C

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001266

License Status

NOT RENEWED

Business

N

First Name

MICHAEL

Middle

ROBERT

Last Name

DEPEW

Suffix

PA-C

Business Name

MICHAEL ROBERT DEPEW PA-C

Original Issue Date

12/23/1999

Effective Date

12/23/1999

Expiration Date

03/01/2002

State

IL

Ever Disciplined

N

LastModifiedDate

10/09/2006