MARY K LANE - Physician Assistant License in Illinois | # 085000746

MARY K LANE

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000746

License Status

NOT RENEWED

Business

N

First Name

MARY K

Last Name

LANE

Business Name

MARY K LANE

Original Issue Date

02/06/1996

Effective Date

12/14/2007

Expiration Date

03/01/2010

State

IL

Ever Disciplined

N

LastModifiedDate

04/01/2010