TAMARA ANN FREDERICK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003236

License Status

NOT RENEWED

Business

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

City

LOMBARD

State

Zip

60148

County

DUPAGE

Ever Disciplined

LastModifiedDate

07/27/2022