SAMUEL WALLACE BRADY - Physician Assistant License in Illinois | # 085008789

SAMUEL WALLACE BRADY

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008789

License Status

NOT RENEWED

Business

N

First Name

SAMUEL

Middle

WALLACE

Last Name

BRADY

Business Name

SAMUEL WALLACE BRADY

Original Issue Date

12/29/2021

Effective Date

12/29/2021

Expiration Date

03/01/2024

State

IL

Ever Disciplined

N

LastModifiedDate

02/05/2025