REGINALD DEMOND LEWIS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005279

License Status

NOT RENEWED

Business

First Name

REGINALD

Middle

DEMOND

Last Name

LEWIS

Business Name

REGINALD DEMOND LEWIS

Original Issue Date

09/30/2014

Effective Date

02/05/2016

Expiration Date

03/01/2018

City

CHICAGO

State

Zip

60613

County

COOK

Ever Disciplined

LastModifiedDate

05/10/2018