ANGELA KATHLEEN VERVOORT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004532

License Status

NOT RENEWED

Business

First Name

ANGELA

Middle

KATHLEEN

Last Name

VERVOORT

Business Name

ANGELA KATHLEEN VERVOORT

Original Issue Date

10/25/2012

Effective Date

03/01/2018

Expiration Date

03/01/2020

City

NAPERVILLE

State

Zip

60564

County

WILL

Ever Disciplined

LastModifiedDate

11/24/2020