GENESIS TAVERAS Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****03

License Status

ACTIVE

Business

First Name

GENESIS

Last Name

TAVERAS

Business Name

GENESIS TAVERAS

Original Issue Date

08/25/2022

Effective Date

01/22/2024

Expiration Date

03/01/2026

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025