JOSELITO E GANNABAN JR MD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000033

License Status

NOT RENEWED

Business

First Name

JOSELITO

Middle

Last Name

GANNABAN

Suffix

JR MD

Business Name

JOSELITO E GANNABAN JR MD

Original Issue Date

11/15/1980

Effective Date

11/15/1980

Expiration Date

03/01/1996

City

ALSIP

State

Zip

60803

County

COOK

Ever Disciplined

LastModifiedDate

11/27/2017