DIANA LEE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****99

License Status

NOT RENEWED

Business

First Name

DIANA

Last Name

LEE

Business Name

DIANA LEE

Original Issue Date

10/03/2011

Effective Date

01/11/2012

Expiration Date

03/01/2014

City

CHICAGO

State

Zip

60616

County

COOK

Ever Disciplined

LastModifiedDate

04/23/2014