DOLORES DROCHNER DISANTO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****22

License Status

NOT RENEWED

Business

First Name

DOLORES

Middle

DROCHNER

Last Name

DISANTO

Business Name

DOLORES DROCHNER DISANTO

Original Issue Date

06/20/2005

Effective Date

06/20/2005

Expiration Date

03/01/2008

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

09/26/2006