JASON M STAFFORD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002879

License Status

NOT RENEWED

Business

First Name

JASON

Middle

Last Name

STAFFORD

Business Name

JASON M STAFFORD

Original Issue Date

11/01/2006

Effective Date

11/01/2006

Expiration Date

03/01/2008

City

MORTON GROVE

State

Zip

60053

County

COOK

Ever Disciplined

LastModifiedDate

04/23/2008