EDWARD GILMORE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000382

License Status

NOT RENEWED

Business

First Name

EDWARD

Last Name

GILMORE

Business Name

EDWARD GILMORE

Original Issue Date

03/17/1990

Effective Date

01/19/2010

Expiration Date

03/01/2012

City

CHICAGO

State

Zip

60618

County

COOK

Ever Disciplined

LastModifiedDate

04/11/2012