AMY M PETTY - Physician Assistant License in Illinois | # 085002349

AMY M PETTY

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002349

License Status

NOT RENEWED

Business

N

First Name

AMY

Middle

M

Last Name

PETTY

Business Name

AMY M PETTY

Original Issue Date

09/23/2004

Effective Date

09/23/2004

Expiration Date

03/01/2006

State

IL

Ever Disciplined

N

LastModifiedDate

10/09/2006