SUSANN L GALLOWAY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000798

License Status

NOT RENEWED

Business

First Name

SUSANN

Middle

Last Name

GALLOWAY

Business Name

SUSANN L GALLOWAY

Original Issue Date

04/09/1996

Effective Date

04/09/1996

Expiration Date

03/01/2006

City

CHICAGO

State

Zip

60635

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006