SUJITHRA REPRAKASH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006949

License Status

NOT RENEWED

Business

First Name

SUJITHRA

Last Name

REPRAKASH

Business Name

SUJITHRA REPRAKASH

Original Issue Date

02/19/2019

Effective Date

02/13/2020

Expiration Date

03/01/2022

City

BOLINGBROOK

State

Zip

60440

County

WILL

Ever Disciplined

LastModifiedDate

07/27/2022