DIANE B FOSTER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000306

License Status

NOT RENEWED

Business

First Name

DIANE

Middle

Last Name

FOSTER

Business Name

DIANE B FOSTER

Original Issue Date

11/15/1985

Effective Date

03/13/2018

Expiration Date

03/01/2020

City

PLAINFIELD

State

Zip

60585

County

WILL

Ever Disciplined

LastModifiedDate

11/24/2020