RANDY ELLIS - Physician Assistant License in Illinois | # 085000027

RANDY ELLIS

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000027

License Status

NOT RENEWED

Business

N

First Name

RANDY

Last Name

ELLIS

Business Name

RANDY ELLIS

Original Issue Date

11/05/1980

Effective Date

11/05/1980

Expiration Date

11/05/1984

State

IL

Ever Disciplined

N

LastModifiedDate

09/26/2006