BRIAN J PRUNTY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****27

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

Last Name

PRUNTY

Business Name

BRIAN J PRUNTY

Original Issue Date

03/20/2001

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

CHICAGO

State

Zip

60608

County

COOK

Ever Disciplined

LastModifiedDate

12/21/2010