JENNIFER MICHELLE YATCHAK BALISI Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003251

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

MICHELLE

Last Name

YATCHAK BALISI

Business Name

JENNIFER MICHELLE YATCHAK BALISI

Original Issue Date

07/30/2008

Effective Date

07/30/2008

Expiration Date

03/01/2010

City

EVANSTON

State

Zip

60202

County

COOK

Ever Disciplined

LastModifiedDate

03/06/2017