ELLEN SARA HARRIS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****13

License Status

NOT RENEWED

Business

First Name

ELLEN

Middle

SARA

Last Name

HARRIS

Business Name

ELLEN SARA HARRIS

Original Issue Date

09/02/2010

Effective Date

02/16/2016

Expiration Date

03/01/2018

City

BERWYN

State

Zip

60402

County

COOK

Ever Disciplined

LastModifiedDate

05/10/2018