COREY W LEO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****02

License Status

NOT RENEWED

Business

First Name

COREY

Middle

Last Name

LEO

Business Name

COREY W LEO

Original Issue Date

10/11/2005

Effective Date

10/11/2005

Expiration Date

03/01/2008

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

09/26/2006