SARAH E GUASTALLI Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005324

License Status

NOT RENEWED

Business

First Name

SARAH

Middle

Last Name

GUASTALLI

Business Name

SARAH E GUASTALLI

Original Issue Date

10/16/2014

Effective Date

02/21/2018

Expiration Date

03/01/2020

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Ever Disciplined

LastModifiedDate

11/24/2020