HOLLY D GINGERICH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004059

License Status

NOT RENEWED

Business

First Name

HOLLY

Middle

Last Name

GINGERICH

Business Name

HOLLY D GINGERICH

Original Issue Date

07/12/2011

Effective Date

01/11/2012

Expiration Date

03/01/2014

City

CHICAGO

State

Zip

60613

County

COOK

Ever Disciplined

LastModifiedDate

07/01/2014