MELISSA LYNNE PORTELL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****72

License Status

NOT RENEWED

Business

First Name

MELISSA

Middle

LYNNE

Last Name

PORTELL

Business Name

MELISSA LYNNE PORTELL

Original Issue Date

08/19/2014

Effective Date

02/17/2016

Expiration Date

03/01/2018

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

05/10/2018