ELISABETH MARIE COOPER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****98

License Status

NOT RENEWED

Business

First Name

ELISABETH

Middle

MARIE

Last Name

COOPER

Business Name

ELISABETH MARIE COOPER

Original Issue Date

02/16/2006

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

OAK BROOK TERRACE

State

Zip

60181

County

DUPAGE

Ever Disciplined

LastModifiedDate

09/23/2010