DOLORES DROCHNER DISANTO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002459

License Status

NOT RENEWED

Business

First Name

DOLORES

Middle

DROCHNER

Last Name

DISANTO

Business Name

DOLORES DROCHNER DISANTO

Original Issue Date

02/10/2005

Effective Date

01/08/2010

Expiration Date

03/01/2012

City

WINNETKA

State

Zip

60093

County

COOK

Ever Disciplined

LastModifiedDate

04/11/2012