SUSIE MY LEE 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

SUSIE

Middle

Last Name

LEE

Business Name

SUSIE MY LEE

Original Issue Date

08/11/2014

Effective Date

02/16/2016

Expiration Date

03/01/2018

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

05/10/2018