MYLES STANDISH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000256

License Status

NOT RENEWED

Business

First Name

MYLES

Last Name

STANDISH

Business Name

MYLES STANDISH

Original Issue Date

08/31/1983

Effective Date

08/31/1983

Expiration Date

08/31/1985

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

09/26/2006