JASON ALLAN GENCO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005647

License Status

NOT RENEWED

Business

First Name

JASON

Middle

ALLAN

Last Name

GENCO

Business Name

JASON ALLAN GENCO

Original Issue Date

09/18/2015

Effective Date

12/24/2019

Expiration Date

03/01/2022

City

NORRIDGE

State

Zip

60706

County

COOK

Ever Disciplined

LastModifiedDate

07/27/2022