KELLY S MACVITTIE - Physician Assistant License in Illinois | # 085001525

KELLY S MACVITTIE

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001525

License Status

NOT RENEWED

Business

N

First Name

KELLY

Middle

S

Last Name

MACVITTIE

Business Name

KELLY S MACVITTIE

Original Issue Date

12/12/2000

Effective Date

12/12/2000

Expiration Date

03/01/2004

State

IL

Ever Disciplined

N

LastModifiedDate

10/09/2006