ALICIA N CARLSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****59

License Status

NOT RENEWED

Business

First Name

ALICIA

Middle

Last Name

CARLSON

Business Name

ALICIA N CARLSON

Original Issue Date

12/14/2005

Effective Date

12/21/2011

Expiration Date

03/01/2014

City

PARK RIDGE

State

Zip

60068

County

COOK

Ever Disciplined

LastModifiedDate

04/08/2014