CARLY NICOLE LARSON - Physician Assistant License in Illinois | # 085004730

CARLY NICOLE LARSON

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004730

License Status

NOT RENEWED

Business

N

First Name

CARLY

Middle

NICOLE

Last Name

LARSON

Business Name

CARLY NICOLE LARSON

Original Issue Date

07/22/2013

Effective Date

01/27/2014

Expiration Date

03/01/2016

State

IL

Ever Disciplined

N

LastModifiedDate

04/25/2016