COOPER LEON RENDON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****63

License Status

NOT RENEWED

Business

First Name

COOPER

Middle

LEON

Last Name

RENDON

Business Name

COOPER LEON RENDON

Original Issue Date

11/10/2011

Effective Date

01/28/2014

Expiration Date

03/01/2016

City

CALUMET CITY

State

Zip

60409

County

COOK

Ever Disciplined

LastModifiedDate

03/24/2016