MARY ELIZABETH F GANNON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001476

License Status

NOT RENEWED

Business

First Name

MARY

Middle

ELIZABETH F

Last Name

GANNON

Business Name

MARY ELIZABETH F GANNON

Original Issue Date

11/08/2000

Effective Date

11/08/2000

Expiration Date

03/01/2002

City

PARK RIDGE

State

Zip

60068

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006