LISA M DANIELS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****83

License Status

NOT RENEWED

Business

First Name

LISA

Middle

Last Name

DANIELS

Business Name

LISA M DANIELS

Original Issue Date

02/04/2008

Effective Date

02/04/2008

Expiration Date

03/01/2010

City

CALUMET CITY

State

Zip

60409

County

COOK

Ever Disciplined

LastModifiedDate

08/29/2008