CAROLYN ROSE PUGH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002156

License Status

NOT RENEWED

Business

First Name

CAROLYN

Middle

ROSE

Last Name

PUGH

Business Name

CAROLYN ROSE PUGH

Original Issue Date

10/27/2003

Effective Date

02/21/2018

Expiration Date

03/01/2020

City

ST CHARLES

State

Zip

60175

County

KANE

Ever Disciplined

LastModifiedDate

11/24/2020