ELIZABETH MARIE DIBELLA Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****23

License Status

NOT RENEWED

Business

First Name

ELIZABETH

Middle

MARIE

Last Name

DIBELLA

Business Name

ELIZABETH MARIE DIBELLA

Original Issue Date

07/16/2014

Effective Date

07/16/2014

Expiration Date

03/01/2016

City

NEW LENOX

State

Zip

60451

County

WILL

Ever Disciplined

LastModifiedDate

04/25/2016