TERESA LYNNE MARTELLO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002229

License Status

NOT RENEWED

Business

First Name

TERESA

Middle

LYNNE

Last Name

MARTELLO

Business Name

TERESA LYNNE MARTELLO

Original Issue Date

03/24/2004

Effective Date

03/04/2010

Expiration Date

03/01/2012

City

CLARENDON HILLS

State

Zip

60514

County

DUPAGE

Ever Disciplined

LastModifiedDate

04/11/2012