JESSICA SUZANNE SMITH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****86

License Status

NOT RENEWED

Business

First Name

JESSICA

Middle

SUZANNE

Last Name

SMITH

Business Name

JESSICA SUZANNE SMITH

Original Issue Date

12/10/2008

Effective Date

02/25/2010

Expiration Date

03/01/2012

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

04/16/2012