JOAN MARIE SULLIVAN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003454

License Status

NOT RENEWED

Business

First Name

JOAN

Middle

MARIE

Last Name

SULLIVAN

Business Name

JOAN MARIE SULLIVAN

Original Issue Date

04/23/2009

Effective Date

01/25/2012

Expiration Date

03/01/2014

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Ever Disciplined

LastModifiedDate

11/05/2015