AMY L BETANCOURT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002039

License Status

NOT RENEWED

Business

First Name

AMY

Middle

Last Name

BETANCOURT

Business Name

AMY L BETANCOURT

Original Issue Date

08/05/2003

Effective Date

08/05/2003

Expiration Date

03/01/2006

City

WAUKEGAN

State

Zip

60085

County

LAKE

Ever Disciplined

LastModifiedDate

10/09/2006