PENNY GRILLOS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****70

License Status

NOT RENEWED

Business

First Name

PENNY

Last Name

GRILLOS

Business Name

PENNY GRILLOS

Original Issue Date

07/08/2002

Effective Date

03/04/2014

Expiration Date

03/01/2016

City

CHICAGO

State

Zip

60634

County

COOK

Ever Disciplined

LastModifiedDate

01/21/2016