KELLY S LICARI Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****35

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

Last Name

LICARI

Business Name

KELLY S LICARI

Original Issue Date

01/02/2002

Effective Date

02/03/2016

Expiration Date

03/01/2018

City

ADDISON

State

Zip

60101

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/10/2018