DIANE LEONARD RACZYKOWSKI Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000071

License Status

NOT RENEWED

Business

First Name

DIANE LEONARD

Last Name

RACZYKOWSKI

Business Name

DIANE LEONARD RACZYKOWSKI

Original Issue Date

11/09/1980

Effective Date

11/09/1980

Expiration Date

11/09/1984

City

FLOSSMOOR

State

Zip

60422

County

COOK

Ever Disciplined

LastModifiedDate

09/26/2006