CATHERINE GRACE ENGIBOUS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****69

License Status

NOT RENEWED

Business

First Name

CATHERINE

Middle

GRACE

Last Name

ENGIBOUS

Business Name

CATHERINE GRACE ENGIBOUS

Original Issue Date

07/13/2010

Effective Date

07/13/2010

Expiration Date

03/01/2012

City

MORTON GROVE

State

Zip

60053

County

COOK

Ever Disciplined

LastModifiedDate

04/16/2012