ANNELIESE HEATHER MIZWICKI - Physician Assistant License in Illinois | # 085004779

ANNELIESE HEATHER MIZWICKI

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004779

License Status

NOT RENEWED

Business

N

First Name

ANNELIESE

Middle

HEATHER

Last Name

MIZWICKI

Business Name

ANNELIESE HEATHER MIZWICKI

Original Issue Date

07/26/2013

Effective Date

01/02/2020

Expiration Date

03/01/2022

State

IL

Ever Disciplined

N

LastModifiedDate

07/27/2022