SARAH MARIE STASIEWICZ 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

SARAH

Middle

MARIE

Last Name

STASIEWICZ

Business Name

SARAH MARIE STASIEWICZ

Original Issue Date

09/07/2016

Effective Date

09/07/2016

Expiration Date

03/01/2018

City

GURNEE

State

Zip

60031

County

LAKE

Ever Disciplined

LastModifiedDate

05/10/2018