Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Nov 25, 2020
License(s)
085.007192 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 2323 GRAND AVE | Waukegan, IL 60085-3312 | 847-666-3494 |
| LOCATION | 2323 GRAND AVE | Waukegan, IL 60085-3312 | 847-666-3494 |
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