KELLY MACKENZIE ARDITI Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****04

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

MACKENZIE

Last Name

ARDITI

Business Name

KELLY MACKENZIE ARDITI

Original Issue Date

03/12/2008

Effective Date

03/12/2008

Expiration Date

03/01/2010

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

02/10/2011