MARCELLE A BULLARD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002401

License Status

NOT RENEWED

Business

First Name

MARCELLE

Middle

Last Name

BULLARD

Business Name

MARCELLE A BULLARD

Original Issue Date

10/29/2004

Effective Date

02/27/2014

Expiration Date

03/01/2016

City

EVANSTON

State

Zip

60202

County

COOK

Ever Disciplined

LastModifiedDate

05/07/2025