MICHAEL R HOLMES Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004479

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

HOLMES

Business Name

MICHAEL R HOLMES

Original Issue Date

10/01/2012

Effective Date

01/29/2014

Expiration Date

03/01/2016

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Ever Disciplined

LastModifiedDate

04/25/2016