DIANE J GIBSON Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000357

License Status

INACTIVE

Business

First Name

DIANE J

Last Name

GIBSON

Business Name

DIANE J GIBSON

Original Issue Date

05/01/1988

Effective Date

05/01/1988

Expiration Date

03/01/1994

City

BERWYN

State

Zip

60402

County

DUPAGE

Ever Disciplined

LastModifiedDate

09/26/2006