BRIAN J PRUNTY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000297

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

Last Name

PRUNTY

Business Name

BRIAN J PRUNTY

Original Issue Date

05/24/1985

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

CHICAGO

State

Zip

60615

County

COOK

Ever Disciplined

LastModifiedDate

12/21/2010