EDWARD C CARLSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000011

License Status

NOT RENEWED

Business

First Name

EDWARD C

Last Name

CARLSON

Business Name

EDWARD C CARLSON

Original Issue Date

11/05/1980

Effective Date

11/05/1980

Expiration Date

03/01/2000

City

LOMBARD

State

Zip

60148

County

DUPAGE

Ever Disciplined

LastModifiedDate

09/26/2006