EILEEN THERESE REILLY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003148

License Status

NOT RENEWED

Business

First Name

EILEEN

Middle

THERESE

Last Name

REILLY

Business Name

EILEEN THERESE REILLY

Original Issue Date

11/13/2007

Effective Date

12/21/2011

Expiration Date

03/01/2014

City

JANESVILLE

State

Zip

53546

County

WISCONSIN

Ever Disciplined

LastModifiedDate

04/08/2014