SARAH GEMMA PUCCINELLI Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002542

License Status

NOT RENEWED

Business

First Name

SARAH

Middle

GEMMA

Last Name

PUCCINELLI

Business Name

SARAH GEMMA PUCCINELLI

Original Issue Date

08/17/2005

Effective Date

02/27/2018

Expiration Date

03/01/2020

City

OAK PARK

State

Zip

60301

Ever Disciplined

LastModifiedDate

11/24/2020