LISA M FANTROY Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001107

License Status

ACTIVE

Business

First Name

LISA

Middle

Last Name

FANTROY

Business Name

LISA M FANTROY

Original Issue Date

01/05/1999

Effective Date

01/22/2026

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60605

County

COOK

Ever Disciplined

LastModifiedDate

01/22/2026