KATINA DAWN WALLINE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002067

License Status

NOT RENEWED

Business

First Name

KATINA

Middle

DAWN

Last Name

WALLINE

Business Name

KATINA DAWN WALLINE

Original Issue Date

08/28/2003

Effective Date

01/04/2012

Expiration Date

03/01/2014

City

CHICAGO

State

Zip

60625

County

COOK

Ever Disciplined

LastModifiedDate

12/28/2015