CARLY K GIETLER Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****67

License Status

INOPERATIVE

Business

First Name

CARLY

Middle

Last Name

GIETLER

Business Name

CARLY K GIETLER

Original Issue Date

11/15/2011

Effective Date

01/22/2014

Expiration Date

03/01/2016

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

07/29/2014