PETER WALLACE LEWIS - Physician Assistant License in Illinois | # 085004035

PETER WALLACE LEWIS

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004035

License Status

NOT RENEWED

Business

N

First Name

PETER

Middle

WALLACE

Last Name

LEWIS

Business Name

PETER WALLACE LEWIS

Original Issue Date

05/25/2011

Effective Date

02/22/2012

Expiration Date

03/01/2014

State

IL

Ever Disciplined

N

LastModifiedDate

04/08/2014