GEORGE X DE LA VEGA PA-C Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000794

License Status

NOT RENEWED

Business

First Name

GEORGE

Middle

Last Name

DE LA VEGA

Suffix

PA-C

Business Name

GEORGE X DE LA VEGA PA-C

Original Issue Date

03/30/1996

Effective Date

03/30/1996

Expiration Date

03/01/1998

City

CHICAGO

State

Zip

60639

County

COOK

Ever Disciplined

LastModifiedDate

09/26/2006