LESLEY ANN PLACEWAY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****29

License Status

NOT RENEWED

Business

First Name

LESLEY

Middle

ANN

Last Name

PLACEWAY

Business Name

LESLEY ANN PLACEWAY

Original Issue Date

11/03/2005

Effective Date

02/17/2010

Expiration Date

03/01/2012

City

HIGHLAND PARK

State

Zip

60035

County

LAKE

Ever Disciplined

LastModifiedDate

04/16/2012