SANDRA MAMDOUH ELKHOULY 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

SANDRA

Middle

MAMDOUH

Last Name

ELKHOULY

Business Name

SANDRA MAMDOUH ELKHOULY

Original Issue Date

10/06/2005

Effective Date

11/15/2006

Expiration Date

03/01/2008

City

LINCOLNSHIRE

State

Zip

60069

County

LAKE

Ever Disciplined

LastModifiedDate

11/08/2006