SUSAN E BORREGARD Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****88

License Status

INOPERATIVE

Business

First Name

SUSAN

Middle

Last Name

BORREGARD

Business Name

SUSAN E BORREGARD

Original Issue Date

01/31/2006

Effective Date

12/27/2011

Expiration Date

03/01/2014

City

OAK LAWN

State

Zip

60453

County

COOK

Ever Disciplined

LastModifiedDate

07/29/2013