DAWN ROSALIE YOUNGBLOOD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****03

License Status

NOT RENEWED

Business

First Name

DAWN

Middle

ROSALIE

Last Name

YOUNGBLOOD

Business Name

DAWN ROSALIE YOUNGBLOOD

Original Issue Date

01/05/2009

Effective Date

04/28/2010

Expiration Date

03/01/2012

City

CHICAGO HEIGHTS

State

Zip

60411

County

COOK

Ever Disciplined

LastModifiedDate

11/18/2015