LYDIA NICOLE MARQUEZ 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

LYDIA

Middle

NICOLE

Last Name

MARQUEZ

Business Name

LYDIA NICOLE MARQUEZ

Original Issue Date

03/07/2006

Effective Date

02/09/2012

Expiration Date

03/01/2014

City

CHICAGO

State

Zip

60608

County

COOK

Ever Disciplined

LastModifiedDate

12/19/2013