TINA T ELACKATT PA-C Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001428

License Status

NOT RENEWED

Business

First Name

TINA T

Last Name

ELACKATT

Suffix

PA-C

Business Name

TINA T ELACKATT PA-C

Original Issue Date

09/28/2000

Effective Date

09/28/2000

Expiration Date

03/01/2004

City

MORTON GROVE

State

Zip

60053

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006