DEANNA ELAINE CULLY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****26

License Status

NOT RENEWED

Business

First Name

DEANNA

Middle

ELAINE

Last Name

CULLY

Business Name

DEANNA ELAINE CULLY

Original Issue Date

11/03/2005

Effective Date

02/19/2008

Expiration Date

03/01/2010

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

04/01/2010