AMY B BERGHOFF - Physician Assistant License in Illinois | # 085005309

AMY B BERGHOFF

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005309

License Status

NOT RENEWED

Business

N

First Name

AMY

Middle

B

Last Name

BERGHOFF

Business Name

AMY B BERGHOFF

Original Issue Date

10/09/2014

Effective Date

03/02/2018

Expiration Date

03/01/2020

State

IL

Ever Disciplined

N

LastModifiedDate

11/24/2020