KRISTINE ELIZABETH BURGESS 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

KRISTINE

Middle

ELIZABETH

Last Name

BURGESS

Business Name

KRISTINE ELIZABETH BURGESS

Original Issue Date

10/04/2010

Effective Date

01/30/2014

Expiration Date

03/01/2016

City

LAKE ZURICH

State

Zip

60047

County

LAKE

Ever Disciplined

LastModifiedDate

03/20/2024