ELENI MARIA MORAITES MD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****05

License Status

NOT RENEWED

Business

Title

First Name

ELENI

Middle

MARIA

Last Name

MORAITES

Business Name

ELENI MARIA MORAITES MD

Original Issue Date

01/04/2007

Effective Date

12/09/2009

Expiration Date

03/01/2012

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

04/16/2012