ELLEN MARIE BOYNTON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****00

License Status

NOT RENEWED

Business

First Name

ELLEN

Middle

MARIE

Last Name

BOYNTON

Business Name

ELLEN MARIE BOYNTON

Original Issue Date

04/15/2011

Effective Date

03/01/2012

Expiration Date

03/01/2014

City

CHICAGO

State

Zip

60616

County

COOK

Ever Disciplined

LastModifiedDate

09/29/2015