MACIEJ G STANCZAK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006431

License Status

NOT RENEWED

Business

First Name

MACIEJ

Middle

Last Name

STANCZAK

Business Name

MACIEJ G STANCZAK

Original Issue Date

10/30/2017

Effective Date

02/22/2018

Expiration Date

03/01/2020

City

PLAINFIELD

State

Zip

60585

County

WILL

Ever Disciplined

LastModifiedDate

11/24/2020