JON STANFORD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000650

License Status

NOT RENEWED

Business

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

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

04/23/2008