BEVERLY BERGANOS JOHNSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002667

License Status

NOT RENEWED

Business

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

City

CHICAGO

State

Zip

60618

County

COOK

Ever Disciplined

LastModifiedDate

05/10/2018