WAYNE C ANDERSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000002

License Status

NOT RENEWED

Business

First Name

WAYNE C

Last Name

ANDERSON

Business Name

WAYNE C ANDERSON

Original Issue Date

11/05/1976

Effective Date

11/05/1976

Expiration Date

11/05/1978

City

CHICAGO

State

Zip

60625

County

COOK

Ever Disciplined

LastModifiedDate

09/26/2006