DOMINIK WIEST - Physician Assistant License in Illinois | # 085007755

DOMINIK WIEST

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007755

License Status

NOT RENEWED

Business

N

First Name

DOMINIK

Last Name

WIEST

Business Name

DOMINIK WIEST

Original Issue Date

06/15/2020

Effective Date

06/15/2020

Expiration Date

03/01/2022

State

IL

Ever Disciplined

N

LastModifiedDate

07/27/2022