SANDRA MAMDOUH ELKHOULY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002503

License Status

NOT RENEWED

Business

First Name

SANDRA

Middle

MAMDOUH

Last Name

ELKHOULY

Business Name

SANDRA MAMDOUH ELKHOULY

Original Issue Date

07/12/2005

Effective Date

11/15/2006

Expiration Date

03/01/2008

City

EVANSTON

State

Zip

60202

County

COOK

Ever Disciplined

LastModifiedDate

04/23/2008