BRANDI RENEE EGIZIO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002108

License Status

NOT RENEWED

Business

First Name

BRANDI

Middle

RENEE

Last Name

EGIZIO

Business Name

BRANDI RENEE EGIZIO

Original Issue Date

10/08/2003

Effective Date

03/02/2016

Expiration Date

03/01/2018

City

MORRIS

State

Zip

60450

County

GRUNDY

Ever Disciplined

LastModifiedDate

05/10/2018