ANGELA MARIE RUSSELL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005098

License Status

NOT RENEWED

Business

First Name

ANGELA

Middle

MARIE

Last Name

RUSSELL

Business Name

ANGELA MARIE RUSSELL

Original Issue Date

07/28/2014

Effective Date

02/16/2016

Expiration Date

03/01/2018

City

CHICAGO

State

Zip

60640

County

COOK

Ever Disciplined

LastModifiedDate

05/10/2018