MARK LOREN DENZINE - Physician Assistant License in Illinois | # 085002348

MARK LOREN DENZINE

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002348

License Status

NOT RENEWED

Business

N

First Name

MARK

Middle

LOREN

Last Name

DENZINE

Business Name

MARK LOREN DENZINE

Original Issue Date

09/23/2004

Effective Date

09/23/2004

Expiration Date

03/01/2006

State

IL

Ever Disciplined

N

LastModifiedDate

10/09/2006