MATTHEW ROBERT GREEN - Physician Assistant License in Illinois | # 085003641

MATTHEW ROBERT GREEN

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003641

License Status

NOT RENEWED

Business

N

First Name

MATTHEW

Middle

ROBERT

Last Name

GREEN

Business Name

MATTHEW ROBERT GREEN

Original Issue Date

10/09/2009

Effective Date

01/22/2010

Expiration Date

03/01/2012

State

IL

Ever Disciplined

N

LastModifiedDate

04/11/2012