GREGORY B STEPHENSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000611

License Status

NOT RENEWED

Business

First Name

GREGORY

Middle

Last Name

STEPHENSON

Business Name

GREGORY B STEPHENSON

Original Issue Date

04/25/1994

Effective Date

02/21/2012

Expiration Date

03/01/2014

City

CHICAGO

State

Zip

60649

County

COOK

Ever Disciplined

LastModifiedDate

01/25/2017