TARA L SKALETSKY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002925

License Status

NOT RENEWED

Business

First Name

TARA

Middle

Last Name

SKALETSKY

Business Name

TARA L SKALETSKY

Original Issue Date

12/21/2006

Effective Date

12/21/2006

Expiration Date

03/01/2008

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

04/23/2008