MICHAEL D STORMONT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****88

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

STORMONT

Business Name

MICHAEL D STORMONT

Original Issue Date

03/16/2001

Effective Date

03/16/2001

Expiration Date

03/01/2004

City

OAK PARK

State

Zip

60302

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006