MARY S OKOLISAN - Physician Assistant License in Illinois | # 085002242

MARY S OKOLISAN

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002242

License Status

NOT RENEWED

Business

N

First Name

MARY

Middle

S

Last Name

OKOLISAN

Business Name

MARY S OKOLISAN

Original Issue Date

04/22/2004

Effective Date

01/14/2010

Expiration Date

03/01/2012

State

IL

Ever Disciplined

N

LastModifiedDate

04/11/2012