COREY D MOOD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002802

License Status

NOT RENEWED

Business

First Name

COREY

Middle

Last Name

MOOD

Business Name

COREY D MOOD

Original Issue Date

09/01/2006

Effective Date

01/05/2010

Expiration Date

03/01/2012

City

MORTON GROVE

State

Zip

60053

County

COOK

Ever Disciplined

LastModifiedDate

04/11/2012