SARAH GEMMA PUCCINELLI 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

SARAH

Middle

GEMMA

Last Name

PUCCINELLI

Business Name

SARAH GEMMA PUCCINELLI

Original Issue Date

01/27/2009

Effective Date

04/24/2014

Expiration Date

03/01/2016

City

CHICAGO

State

Zip

60608

County

COOK

Ever Disciplined

LastModifiedDate

03/31/2016