KASSIA ROSE FORTUNA - Physician Assistant License in Illinois | # 085006086

KASSIA ROSE FORTUNA

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006086

License Status

NOT RENEWED

Business

N

First Name

KASSIA

Middle

ROSE

Last Name

FORTUNA

Business Name

KASSIA ROSE FORTUNA

Original Issue Date

12/07/2016

Effective Date

12/24/2019

Expiration Date

03/01/2022

State

IL

Ever Disciplined

N

LastModifiedDate

07/27/2022