MARY JO BANG Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000181

License Status

NOT RENEWED

Business

First Name

MARY JO

Last Name

BANG

Business Name

MARY JO BANG

Original Issue Date

06/15/1980

Effective Date

06/15/1980

Expiration Date

03/01/1988

City

EVANSTON

State

Zip

60201

County

COOK

Ever Disciplined

LastModifiedDate

09/26/2006