Indiana
Professional Licensing Agency
Thomas Alan Joseph Prokop
Temporary Physician Assistant Permit
License number
99064778A
Date granted
11/13/2014
Date expires
08/13/2015
Class
Temporary Physician Assistant Permit
Status
Active
Address
Orland Park IL 60467
indianalicensing.org
ID 29181058
LAST UPDATED 2024-02-26 16:11:13 UTC
LAST UPDATED 2024-02-26 16:11:13 UTC
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