ANGEL L DEJESUS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000449

License Status

NOT RENEWED

Business

First Name

ANGEL L

Last Name

DEJESUS

Business Name

ANGEL L DEJESUS

Original Issue Date

05/09/1991

Effective Date

05/09/1991

Expiration Date

03/01/1996

City

CHICAGO

State

Zip

60647

County

COOK

Ever Disciplined

LastModifiedDate

12/29/2011

Case Number

2009009900

Action

Refuse To Renew

Discipline Start Date

12/04/2009

Discipline End Date

12/29/2011

Discipline Reason

due to conviction of an offense requiring sex offender registration.