SAMANTHA R WENNERBERG - Physician Assistant License in Illinois | # 085003989

SAMANTHA R WENNERBERG

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003989

License Status

NOT RENEWED

Business

N

First Name

SAMANTHA

Middle

R

Last Name

WENNERBERG

Business Name

SAMANTHA R WENNERBERG

Original Issue Date

02/08/2011

Effective Date

02/08/2011

Expiration Date

03/01/2012

State

IL

Ever Disciplined

N

LastModifiedDate

11/23/2015