TAMARA ANN FREDERICK - Physician Assistant License in Illinois | # 085003236

TAMARA ANN FREDERICK

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003236

License Status

NOT RENEWED

Business

N

First Name

TAMARA

Middle

ANN

Last Name

FREDERICK

Business Name

TAMARA ANN FREDERICK

Original Issue Date

06/30/2008

Effective Date

02/25/2020

Expiration Date

03/01/2022

State

IL

Ever Disciplined

N

LastModifiedDate

07/27/2022