XIMENA ELIZABETH GUMPEL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****74

License Status

NOT RENEWED

Business

First Name

XIMENA

Middle

ELIZABETH

Last Name

GUMPEL

Business Name

XIMENA ELIZABETH GUMPEL

Original Issue Date

10/30/2007

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

04/01/2010