SUSIE MY LEE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004986

License Status

NOT RENEWED

Business

First Name

SUSIE

Middle

Last Name

LEE

Business Name

SUSIE MY LEE

Original Issue Date

01/30/2014

Effective Date

02/16/2016

Expiration Date

03/01/2018

City

CHICAGO

State

Zip

60625

County

COOK

Ever Disciplined

LastModifiedDate

05/10/2018