BRIAN C DOUGLASS - Physician Assistant License in Illinois | # 085004083

BRIAN C DOUGLASS

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004083

License Status

NOT RENEWED

Business

N

First Name

BRIAN

Middle

C

Last Name

DOUGLASS

Business Name

BRIAN C DOUGLASS

Original Issue Date

07/20/2011

Effective Date

02/22/2012

Expiration Date

03/01/2014

State

IL

Ever Disciplined

N

LastModifiedDate

02/05/2015