COLLEEN M BIRD Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001730

License Status

INACTIVE

Business

First Name

COLLEEN

Middle

Last Name

BIRD

Business Name

COLLEEN M BIRD

Original Issue Date

11/30/2001

Effective Date

01/06/2020

Expiration Date

03/01/2022

City

SOUTH ELGIN

State

Zip

60177

County

KANE

Ever Disciplined

LastModifiedDate

01/26/2022