DIANA E PEREZ Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004231

License Status

NOT RENEWED

Business

First Name

DIANA

Middle

Last Name

PEREZ

Business Name

DIANA E PEREZ

Original Issue Date

10/27/2011

Effective Date

03/13/2018

Expiration Date

03/01/2020

City

MELROSE PARK

State

Zip

60160

County

COOK

Ever Disciplined

LastModifiedDate

11/24/2020