TERRA L GRYWALSKI Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003767

License Status

NOT RENEWED

Business

First Name

TERRA

Middle

Last Name

GRYWALSKI

Business Name

TERRA L GRYWALSKI

Original Issue Date

06/23/2010

Effective Date

06/23/2010

Expiration Date

03/01/2012

City

CHICAGO

State

Zip

60661

County

COOK

Ever Disciplined

LastModifiedDate

04/11/2012