MARTY EDWARD WILSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000225

License Status

NOT RENEWED

Business

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

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

09/26/2006