KELSEY LASAGE MAZUR - Physician Assistant License in Illinois | # 085006470

KELSEY LASAGE MAZUR

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006470

License Status

NOT RENEWED

Business

N

First Name

KELSEY

Middle

LASAGE

Last Name

MAZUR

Business Name

KELSEY LASAGE MAZUR

Original Issue Date

12/20/2017

Effective Date

01/21/2020

Expiration Date

03/01/2022

State

IL

Ever Disciplined

N

LastModifiedDate

07/27/2022