SUSAN LANE BUGAJSKY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001185

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

LANE

Last Name

BUGAJSKY

Business Name

SUSAN LANE BUGAJSKY

Original Issue Date

01/12/1999

Effective Date

01/12/1999

Expiration Date

03/01/2004

City

WESTMONT

State

Zip

60559

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/09/2006