JESSICA ALYCE HAISLEY Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****56

License Status

INOPERATIVE

Business

First Name

JESSICA

Middle

ALYCE

Last Name

HAISLEY

Business Name

JESSICA ALYCE HAISLEY

Original Issue Date

12/13/2005

Effective Date

01/19/2012

Expiration Date

03/01/2014

City

SOUTH ELGIN

State

Zip

60177

County

KANE

Ever Disciplined

LastModifiedDate

01/19/2012