HOLLY SUSANNE WILLMANN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001715

License Status

NOT RENEWED

Business

First Name

HOLLY

Middle

SUSANNE

Last Name

WILLMANN

Business Name

HOLLY SUSANNE WILLMANN

Original Issue Date

11/20/2001

Effective Date

11/20/2001

Expiration Date

03/01/2006

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006