MELLANIE SLAVICH MERRIT 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

MELLANIE

Middle

SLAVICH

Last Name

MERRIT

Business Name

MELLANIE SLAVICH MERRIT

Original Issue Date

01/06/2012

Effective Date

01/06/2012

Expiration Date

03/01/2014

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

03/16/2015