LESLIE E BERKI MASON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****01

License Status

NOT RENEWED

Business

First Name

LESLIE

Middle

Last Name

BERKI MASON

Business Name

LESLIE E BERKI MASON

Original Issue Date

11/16/2007

Effective Date

03/01/2012

Expiration Date

03/01/2014

City

GENEVA

State

Zip

60134

County

KANE

Ever Disciplined

LastModifiedDate

03/22/2016