BRIANNE PATRICIA RANDALL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004735

License Status

NOT RENEWED

Business

First Name

BRIANNE

Middle

PATRICIA

Last Name

RANDALL

Business Name

BRIANNE PATRICIA RANDALL

Original Issue Date

07/22/2013

Effective Date

02/26/2014

Expiration Date

03/01/2016

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

04/25/2016