DIANA ELIZABETH GUILLEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003179

License Status

NOT RENEWED

Business

First Name

DIANA

Middle

ELIZABETH

Last Name

GUILLEN

Business Name

DIANA ELIZABETH GUILLEN

Original Issue Date

01/22/2008

Effective Date

02/09/2010

Expiration Date

03/01/2012

City

EVANSTON

State

Zip

60202

County

COOK

Ever Disciplined

LastModifiedDate

11/20/2015