KOMAL J PATEL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005429

License Status

NOT RENEWED

Business

First Name

KOMAL

Middle

Last Name

PATEL

Business Name

KOMAL J PATEL

Original Issue Date

02/26/2015

Effective Date

02/09/2016

Expiration Date

03/01/2018

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

05/10/2018