LISA MARIE GUNDERSEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001225

License Status

NOT RENEWED

Business

First Name

LISA

Middle

MARIE

Last Name

GUNDERSEN

Business Name

LISA MARIE GUNDERSEN

Original Issue Date

06/29/1999

Effective Date

06/29/1999

Expiration Date

03/01/2006

City

NAPERVILLE

State

Zip

60564

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/09/2006