LAURIE J MOTTL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****14

License Status

NOT RENEWED

Business

First Name

LAURIE

Middle

Last Name

MOTTL

Business Name

LAURIE J MOTTL

Original Issue Date

05/13/2005

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

04/01/2010