DEANNE CLELIA FORNELLI Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003925

License Status

ACTIVE

Business

First Name

DEANNE

Middle

CLELIA

Last Name

FORNELLI

Business Name

DEANNE CLELIA FORNELLI

Original Issue Date

10/05/2010

Effective Date

12/04/2025

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

12/04/2025