LAURIE A LISAK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****97

License Status

NOT RENEWED

Business

First Name

LAURIE

Middle

Last Name

LISAK

Business Name

LAURIE A LISAK

Original Issue Date

03/23/2001

Effective Date

03/23/2001

Expiration Date

03/01/2004

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006