MARTY EDWARD WILSON - Physician Assistant License in Illinois | # 085000225

MARTY EDWARD WILSON

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000225

License Status

NOT RENEWED

Business

N

First Name

MARTY EDWARD

Last Name

WILSON

Business Name

MARTY EDWARD WILSON

Original Issue Date

12/10/1981

Effective Date

12/10/1981

Expiration Date

12/10/1983

State

IL

Ever Disciplined

N

LastModifiedDate

09/26/2006