ANDREW IVAN MULLEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002101

License Status

NOT RENEWED

Business

First Name

ANDREW

Middle

IVAN

Last Name

MULLEN

Business Name

ANDREW IVAN MULLEN

Original Issue Date

09/30/2003

Effective Date

01/16/2014

Expiration Date

03/01/2016

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

04/25/2016