ANDREW THOMAS DOHERTY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003763

License Status

NOT RENEWED

Business

First Name

ANDREW

Middle

THOMAS

Last Name

DOHERTY

Business Name

ANDREW THOMAS DOHERTY

Original Issue Date

06/22/2010

Effective Date

02/25/2016

Expiration Date

03/01/2018

City

DEKALB

State

Zip

60115

County

DEKALB

Ever Disciplined

LastModifiedDate

05/10/2018