ELIZABETH DOROTHEA CARLISLE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****21

License Status

NOT RENEWED

Business

First Name

ELIZABETH

Middle

DOROTHEA

Last Name

CARLISLE

Business Name

ELIZABETH DOROTHEA CARLISLE

Original Issue Date

11/10/2009

Effective Date

02/16/2012

Expiration Date

03/01/2014

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

04/18/2016