ERICA MARIE DEFORD - Physician Assistant License in Illinois | # 085003126

ERICA MARIE DEFORD

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003126

License Status

NOT RENEWED

Business

N

First Name

ERICA

Middle

MARIE

Last Name

DEFORD

Business Name

ERICA MARIE DEFORD

Original Issue Date

10/23/2007

Effective Date

02/05/2020

Expiration Date

03/01/2022

State

IL

Ever Disciplined

N

LastModifiedDate

07/27/2022