ERIC WILLIAM VICKREY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002117

License Status

NOT RENEWED

Business

First Name

ERIC

Middle

WILLIAM

Last Name

VICKREY

Business Name

ERIC WILLIAM VICKREY

Original Issue Date

10/14/2003

Effective Date

01/15/2014

Expiration Date

03/01/2016

City

EVANSTON

State

Zip

60202

County

COOK

Ever Disciplined

LastModifiedDate

08/04/2016