JON STANFORD - Physician Assistant License in Illinois | # 085000650

JON STANFORD

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000650

License Status

NOT RENEWED

Business

N

First Name

JON

Last Name

STANFORD

Business Name

JON STANFORD

Original Issue Date

12/19/1994

Effective Date

12/19/1994

Expiration Date

03/01/2008

State

IL

Ever Disciplined

N

LastModifiedDate

04/23/2008