THERESE E SULLIVAN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003070

License Status

NOT RENEWED

Business

First Name

THERESE

Middle

Last Name

SULLIVAN

Business Name

THERESE E SULLIVAN

Original Issue Date

09/26/2007

Effective Date

02/26/2016

Expiration Date

03/01/2018

City

LEMONT

State

Zip

60439

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/10/2018