LETITIA LORRAINE MALONE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002402

License Status

NOT RENEWED

Business

First Name

LETITIA

Middle

LORRAINE

Last Name

MALONE

Business Name

LETITIA LORRAINE MALONE

Original Issue Date

10/29/2004

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

CHICAGO

State

Zip

60615

County

COOK

Ever Disciplined

LastModifiedDate

04/01/2010