EDWARD GILMORE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****64

License Status

NOT RENEWED

Business

First Name

EDWARD

Last Name

GILMORE

Business Name

EDWARD GILMORE

Original Issue Date

04/10/2007

Effective Date

09/07/2010

Expiration Date

03/01/2012

City

CHICAGO

State

Zip

60646

County

COOK

Ever Disciplined

LastModifiedDate

04/16/2012