TRICIA M MANALASTAS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001801

License Status

NOT RENEWED

Business

First Name

TRICIA

Middle

Last Name

MANALASTAS

Business Name

TRICIA M MANALASTAS

Original Issue Date

06/28/2002

Effective Date

06/28/2002

Expiration Date

03/01/2004

City

DES PLAINES

State

Zip

60016

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006