BRIAN J PRUNTY - Physician Assistant License in Illinois | # 085000297

BRIAN J PRUNTY

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000297

License Status

NOT RENEWED

Business

N

First Name

BRIAN

Middle

J

Last Name

PRUNTY

Business Name

BRIAN J PRUNTY

Original Issue Date

05/24/1985

Effective Date

12/14/2007

Expiration Date

03/01/2010

State

IL

Ever Disciplined

N

LastModifiedDate

12/21/2010