LISA MICHELLE BERRA Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****09

License Status

NOT RENEWED

Business

First Name

LISA

Middle

MICHELLE

Last Name

BERRA

Business Name

LISA MICHELLE BERRA

Original Issue Date

07/23/2009

Effective Date

02/24/2014

Expiration Date

03/01/2016

City

CHICAGO

State

Zip

60642

County

COOK

Ever Disciplined

LastModifiedDate

12/15/2017