AMANDA MARIE DIAMOND Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****79

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

MARIE

Last Name

DIAMOND

Business Name

AMANDA MARIE DIAMOND

Original Issue Date

12/06/2006

Effective Date

06/01/2016

Expiration Date

03/01/2018

City

CHICAGO

State

Zip

60642

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2018