PENNY GRILLOS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000522

License Status

NOT RENEWED

Business

First Name

PENNY

Last Name

GRILLOS

Business Name

PENNY GRILLOS

Original Issue Date

02/08/1993

Effective Date

01/04/2019

Expiration Date

03/01/2020

City

CHICAGO

State

Zip

60634

County

COOK

Ever Disciplined

LastModifiedDate

11/24/2020