KRISTIE KATHLEEN BONNER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****55

License Status

NOT RENEWED

Business

First Name

KRISTIE

Middle

KATHLEEN

Last Name

BONNER

Business Name

KRISTIE KATHLEEN BONNER

Original Issue Date

11/06/2006

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

CHICAGO

State

Zip

60610

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2010