SIMON FARID MIZYED - Physician Assistant License in Illinois | # 085001799

SIMON FARID MIZYED

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001799

License Status

NOT RENEWED

Business

N

First Name

SIMON

Middle

FARID

Last Name

MIZYED

Business Name

SIMON FARID MIZYED

Original Issue Date

06/05/2002

Effective Date

06/05/2002

Expiration Date

03/01/2008

State

IL

Ever Disciplined

N

LastModifiedDate

04/23/2008