JASON M STAFFORD - Physician Assistant License in Illinois | # 085002879

JASON M STAFFORD

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002879

License Status

NOT RENEWED

Business

N

First Name

JASON

Middle

M

Last Name

STAFFORD

Business Name

JASON M STAFFORD

Original Issue Date

11/01/2006

Effective Date

11/01/2006

Expiration Date

03/01/2008

State

IL

Ever Disciplined

N

LastModifiedDate

04/23/2008