MERIN MARY THOMAS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****36

License Status

NOT RENEWED

Business

First Name

MERIN

Middle

MARY

Last Name

THOMAS

Business Name

MERIN MARY THOMAS

Original Issue Date

06/01/2017

Effective Date

05/19/2018

Expiration Date

03/01/2020

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

11/24/2020