TYLER KEITH JOHNSON - Physician Assistant License in Illinois | # 085005949

TYLER KEITH JOHNSON

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005949

License Status

NOT RENEWED

Business

N

First Name

TYLER

Middle

KEITH

Last Name

JOHNSON

Business Name

TYLER KEITH JOHNSON

Original Issue Date

08/26/2016

Effective Date

02/21/2018

Expiration Date

03/01/2020

State

IL

Ever Disciplined

N

LastModifiedDate

11/24/2020