GRACE TERRY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000167

License Status

NOT RENEWED

Business

First Name

GRACE

Last Name

TERRY

Business Name

GRACE TERRY

Original Issue Date

04/14/1981

Effective Date

04/14/1981

Expiration Date

04/14/1985

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

09/26/2006