BRIANNE PATRICIA RANDALL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****31

License Status

NOT RENEWED

Business

First Name

BRIANNE

Middle

PATRICIA

Last Name

RANDALL

Business Name

BRIANNE PATRICIA RANDALL

Original Issue Date

10/25/2013

Effective Date

02/26/2014

Expiration Date

03/01/2016

City

CHICAGO

State

Zip

60608

County

COOK

Ever Disciplined

LastModifiedDate

04/25/2016