DANA MARIE FIELDS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003403

License Status

NOT RENEWED

Business

First Name

DANA

Middle

MARIE

Last Name

FIELDS

Business Name

DANA MARIE FIELDS

Original Issue Date

01/06/2009

Effective Date

03/01/2010

Expiration Date

03/01/2012

City

KILDEER

State

Zip

60047

County

LAKE

Ever Disciplined

LastModifiedDate

04/11/2012