JENNIFER MICHELLE YATCHAK BALISI Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****48

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

MICHELLE

Last Name

YATCHAK BALISI

Business Name

JENNIFER MICHELLE YATCHAK BALISI

Original Issue Date

10/28/2008

Effective Date

10/28/2008

Expiration Date

03/01/2010

City

VERNON HILLS

State

Zip

60061

County

LAKE

Ever Disciplined

LastModifiedDate

10/06/2016