Angel Pemayun Anak-Agung-Gede
ExpiredIllinois license 085007079
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 085007079
- Status
- Expired (Not Renewed)
- First issued
- June 17, 2019
- Expired
- March 1, 2022
- License holder
- Angel Pemayun Anak-Agung-Gede
- Entity type
- Individual
Classifications
- Licensed Physician Assistant Physicians & Surgeons
More from the license record
- Current term began
- 01/21/2020
Contact
San Diego, CA 92121