CARLY N GIACOMO - Physician Assistant License in Illinois | # 085007365

CARLY N GIACOMO

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007365

License Status

NOT RENEWED

Business

N

First Name

CARLY

Middle

N

Last Name

GIACOMO

Prefix

MR

Business Name

CARLY N GIACOMO

Original Issue Date

10/17/2019

Effective Date

02/21/2022

Expiration Date

03/01/2024

State

IL

Ever Disciplined

N

LastModifiedDate

02/05/2025