MELISSA B LIST Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****61

License Status

NOT RENEWED

Business

First Name

MELISSA

Middle

Last Name

LIST

Business Name

MELISSA B LIST

Original Issue Date

09/01/2005

Effective Date

01/16/2014

Expiration Date

03/01/2016

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

03/17/2016