Registry details
Type
Individual
Primary specialty
Physician Assistant, Medical
Enumerated
Aug 29, 2007
License(s)
085003011 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 731 N SANGAMON ST 2ND FLOOR | Chicago, IL 60642-5955 | 312-985-7150 |
| LOCATION | 731 N SANGAMON ST 2ND FLOOR | Chicago, IL 60642-5955 | 312-985-7150 |
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