KELLY MARIE POLETIS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004402

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

MARIE

Last Name

POLETIS

Business Name

KELLY MARIE POLETIS

Original Issue Date

08/13/2012

Effective Date

02/05/2016

Expiration Date

03/01/2018

City

CHICAGO

State

Zip

60605

County

COOK

Ever Disciplined

LastModifiedDate

05/10/2018