ROLAND C FULL - Physician Assistant License in Illinois | # 085000031

ROLAND C FULL

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000031

License Status

INACTIVE

Business

N

First Name

ROLAND

Middle

C

Last Name

FULL

Business Name

ROLAND C FULL

Original Issue Date

11/05/1980

Effective Date

11/05/1980

Expiration Date

03/01/2004

State

IL

Ever Disciplined

N

LastModifiedDate

10/09/2006