EMILY VICTORIA BERGANINI Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005767

License Status

NOT RENEWED

Business

First Name

EMILY

Middle

VICTORIA

Last Name

BERGANINI

Business Name

EMILY VICTORIA BERGANINI

Original Issue Date

01/29/2016

Effective Date

01/29/2016

Expiration Date

03/01/2018

City

CHICAGO

State

Zip

60622

Ever Disciplined

LastModifiedDate

05/10/2018