LARRY L ROSE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000161

License Status

NOT RENEWED

Business

First Name

LARRY L

Last Name

ROSE

Business Name

LARRY L ROSE

Original Issue Date

04/14/1979

Effective Date

04/14/1979

Expiration Date

04/14/1984

City

CHICAGO

State

Zip

60620

County

COOK

Ever Disciplined

LastModifiedDate

09/26/2006