AMY MARIE WILLSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****66

License Status

NOT RENEWED

Business

First Name

AMY

Middle

MARIE

Last Name

WILLSON

Business Name

AMY MARIE WILLSON

Original Issue Date

12/21/2005

Effective Date

12/21/2005

Expiration Date

03/01/2008

City

LA GRANGE

State

Zip

60525

County

COOK

Ever Disciplined

LastModifiedDate

12/08/2015