ERIC DUSTIN WOOD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004084

License Status

NOT RENEWED

Business

First Name

ERIC

Middle

DUSTIN

Last Name

WOOD

Business Name

ERIC DUSTIN WOOD

Original Issue Date

07/21/2011

Effective Date

01/31/2012

Expiration Date

03/01/2014

City

CHICAGO

State

Zip

60622

County

COOK

Ever Disciplined

LastModifiedDate

12/24/2015