CARLY N GIACOMO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007365

License Status

NOT RENEWED

Business

First Name

CARLY

Middle

Last Name

GIACOMO

Prefix

Business Name

CARLY N GIACOMO

Original Issue Date

10/17/2019

Effective Date

02/21/2022

Expiration Date

03/01/2024

City

CHANNAHON

State

Zip

60410

County

WILL

Ever Disciplined

LastModifiedDate

02/05/2025