BRANDI RENEE EGIZIO Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****50

License Status

INOPERATIVE

Business

First Name

BRANDI

Middle

RENEE

Last Name

EGIZIO

Business Name

BRANDI RENEE EGIZIO

Original Issue Date

02/04/2004

Effective Date

03/03/2016

Expiration Date

03/01/2018

City

TINLEY PARK

State

Zip

60487

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2018