NATASHA FOLDA O'GORMAN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002971

License Status

NOT RENEWED

Business

First Name

NATASHA

Middle

FOLDA

Last Name

O'GORMAN

Business Name

NATASHA FOLDA O'GORMAN

Original Issue Date

06/18/2007

Effective Date

02/14/2012

Expiration Date

03/01/2014

City

CHICAGO

State

Zip

60618

County

COOK

Ever Disciplined

LastModifiedDate

04/08/2014