JOLLY ABRAHAM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****00

License Status

NOT RENEWED

Business

First Name

JOLLY

Last Name

ABRAHAM

Business Name

JOLLY ABRAHAM

Original Issue Date

11/15/2007

Effective Date

03/11/2014

Expiration Date

03/01/2016

City

CHICAGO

State

Zip

60642

County

COOK

Ever Disciplined

LastModifiedDate

04/25/2016