MICHAEL A COSTINE - Physician Assistant License in Illinois | # 085007256

MICHAEL A COSTINE

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007256

License Status

NOT RENEWED

Business

N

First Name

MICHAEL

Middle

A

Last Name

COSTINE

Business Name

MICHAEL A COSTINE

Original Issue Date

09/06/2019

Effective Date

01/10/2020

Expiration Date

03/01/2022

State

IL

Ever Disciplined

N

LastModifiedDate

07/27/2022