ALEXANDER STANLEY PORUCZNIK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007291

License Status

NOT RENEWED

Business

First Name

ALEXANDER

Middle

STANLEY

Last Name

PORUCZNIK

Business Name

ALEXANDER STANLEY PORUCZNIK

Original Issue Date

09/19/2019

Effective Date

01/17/2022

Expiration Date

03/01/2024

City

CHICAGO

State

Zip

60661

Ever Disciplined

LastModifiedDate

02/05/2025