KIRT LEE EDLY - Physician Assistant License in Illinois | # 085003072

KIRT LEE EDLY

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003072

License Status

NOT RENEWED

Business

N

First Name

KIRT

Middle

LEE

Last Name

EDLY

Business Name

KIRT LEE EDLY

Original Issue Date

09/27/2007

Effective Date

03/01/2010

Expiration Date

03/01/2012

State

IL

Ever Disciplined

N

LastModifiedDate

04/11/2012