BEVERLY BERGANOS JOHNSON - Physician Assistant License in Illinois | # 085002667

BEVERLY BERGANOS JOHNSON

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002667

License Status

NOT RENEWED

Business

N

First Name

BEVERLY

Middle

BERGANOS

Last Name

JOHNSON

Business Name

BEVERLY BERGANOS JOHNSON

Original Issue Date

11/21/2005

Effective Date

02/04/2016

Expiration Date

03/01/2018

State

IL

Ever Disciplined

N

LastModifiedDate

05/10/2018