STEPHANIE CARROLL WILLIAMS Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****69

License Status

INOPERATIVE

Business

First Name

STEPHANIE

Middle

CARROLL

Last Name

WILLIAMS

Business Name

STEPHANIE CARROLL WILLIAMS

Original Issue Date

12/31/2014

Effective Date

02/05/2016

Expiration Date

03/01/2018

City

EVANSTON

State

Zip

60201

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2018