MEGAN A MASK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004279

License Status

NOT RENEWED

Business

First Name

MEGAN

Middle

Last Name

MASK

Business Name

MEGAN A MASK

Original Issue Date

02/08/2012

Effective Date

01/23/2014

Expiration Date

03/01/2016

City

NAPERVILLE

State

Zip

60563

County

DUPAGE

Ever Disciplined

LastModifiedDate

04/25/2016