JOAN MARIE SULLIVAN 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

JOAN

Middle

MARIE

Last Name

SULLIVAN

Business Name

JOAN MARIE SULLIVAN

Original Issue Date

06/08/2009

Effective Date

01/25/2012

Expiration Date

03/01/2014

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Ever Disciplined

LastModifiedDate

11/05/2015