KIMBERLY NICOLE LAVELLE - Physician Assistant License in Illinois | # 085004129

KIMBERLY NICOLE LAVELLE

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004129

License Status

NOT RENEWED

Business

N

First Name

KIMBERLY

Middle

NICOLE

Last Name

LAVELLE

Business Name

KIMBERLY NICOLE LAVELLE

Original Issue Date

09/14/2011

Effective Date

02/02/2016

Expiration Date

03/01/2018

State

IL

Ever Disciplined

N

LastModifiedDate

08/27/2018