MADISON RAE FERGUSON - Physician Assistant License in Illinois | # 085007303

MADISON RAE FERGUSON

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007303

License Status

NOT RENEWED

Business

N

First Name

MADISON

Middle

RAE

Last Name

FERGUSON

Business Name

MADISON RAE FERGUSON

Original Issue Date

09/26/2019

Effective Date

01/21/2020

Expiration Date

03/01/2022

State

IL

Ever Disciplined

N

LastModifiedDate

07/27/2022