LENNI R FUGAZY - Physician Assistant License in Illinois | # 085002149

LENNI R FUGAZY

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002149

License Status

NOT RENEWED

Business

N

First Name

LENNI

Middle

R

Last Name

FUGAZY

Business Name

LENNI R FUGAZY

Original Issue Date

10/23/2003

Effective Date

01/23/2014

Expiration Date

03/01/2016

State

IL

Ever Disciplined

N

LastModifiedDate

06/23/2016