JAC A CLEMENT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001577

License Status

NOT RENEWED

Business

First Name

JAC

Middle

Last Name

CLEMENT

Business Name

JAC A CLEMENT

Original Issue Date

05/21/2001

Effective Date

05/21/2001

Expiration Date

03/01/2006

City

CHICAGO

State

Zip

60622

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006