MARIANNE GOULD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****93

License Status

NOT RENEWED

Business

First Name

MARIANNE

Last Name

GOULD

Business Name

MARIANNE GOULD

Original Issue Date

09/06/2006

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

CHICAGO

State

Zip

60622

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2010