LAURIE J MOTTL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002366

License Status

NOT RENEWED

Business

First Name

LAURIE

Middle

Last Name

MOTTL

Business Name

LAURIE J MOTTL

Original Issue Date

10/04/2004

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

CHICAGO

State

Zip

60661

County

COOK

Ever Disciplined

LastModifiedDate

04/01/2010