ALICIA N CARLSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002338

License Status

NOT RENEWED

Business

First Name

ALICIA

Middle

Last Name

CARLSON

Business Name

ALICIA N CARLSON

Original Issue Date

09/17/2004

Effective Date

12/21/2011

Expiration Date

03/01/2014

City

PARK RIDGE

State

Zip

60068

County

COOK

Ever Disciplined

LastModifiedDate

04/08/2014