HAZEM N TILLAWI Perfusionist License verification

Business Entity

NOT RENEWED

License Type

Perfusionist

Description

LICENSED PERFUSIONIST

License Number

214000062

License Status

NOT RENEWED

Business

First Name

HAZEM

Middle

Last Name

TILLAWI

Business Name

HAZEM N TILLAWI

Original Issue Date

09/16/2002

Effective Date

05/04/2004

Expiration Date

04/30/2006

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Ever Disciplined

LastModifiedDate

11/15/2006