SUSAN E BORREGARD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001844

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

Last Name

BORREGARD

Business Name

SUSAN E BORREGARD

Original Issue Date

08/09/2002

Effective Date

12/27/2011

Expiration Date

03/01/2014

City

OAK LAWN

State

Zip

60453

County

COOK

Ever Disciplined

LastModifiedDate

04/08/2014