TRACEY LEE GODLEWSKI PA-C Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001892

License Status

NOT RENEWED

Business

First Name

TRACEY

Middle

LEE

Last Name

GODLEWSKI

Suffix

PA-C

Business Name

TRACEY LEE GODLEWSKI PA-C

Original Issue Date

10/02/2002

Effective Date

10/02/2002

Expiration Date

03/01/2004

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/09/2006