MATTHEW A FROMAN 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

MATTHEW A

Last Name

FROMAN

Business Name

MATTHEW A FROMAN

Original Issue Date

09/05/2002

Effective Date

09/05/2002

Expiration Date

03/01/2004

City

ELMHURST

State

Zip

60126

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/09/2006