SUZETTE SUK FONG LEE 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

SUZETTE SUK

Middle

FONG

Last Name

LEE

Business Name

SUZETTE SUK FONG LEE

Original Issue Date

04/13/2011

Effective Date

04/13/2011

Expiration Date

03/01/2012

City

PARK RIDGE

State

Zip

60068

County

COOK

Ever Disciplined

LastModifiedDate

04/11/2012