MICHAEL ROBERT DEPEW PA-C Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001266

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

ROBERT

Last Name

DEPEW

Suffix

PA-C

Business Name

MICHAEL ROBERT DEPEW PA-C

Original Issue Date

12/23/1999

Effective Date

12/23/1999

Expiration Date

03/01/2002

City

DES PLAINES

State

Zip

60016

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006