HOLLY D GINGERICH 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

HOLLY

Middle

Last Name

GINGERICH

Business Name

HOLLY D GINGERICH

Original Issue Date

09/27/2011

Effective Date

01/11/2012

Expiration Date

03/01/2014

City

TINLEY PARK

State

Zip

60487

County

COOK

Ever Disciplined

LastModifiedDate

07/01/2014