MICHELLE L SANFILIPPO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****42

License Status

NOT RENEWED

Business

First Name

MICHELLE

Middle

Last Name

SANFILIPPO

Business Name

MICHELLE L SANFILIPPO

Original Issue Date

05/08/2002

Effective Date

02/22/2018

Expiration Date

03/01/2020

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

11/24/2020