AMY LYNN RONTAL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****95

License Status

NOT RENEWED

Business

First Name

AMY

Middle

LYNN

Last Name

RONTAL

Business Name

AMY LYNN RONTAL

Original Issue Date

03/05/2002

Effective Date

03/05/2002

Expiration Date

03/01/2006

City

LA GRANGE

State

Zip

60525

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006