BRIAN DAVID AMUNDSON Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****04

License Status

ACTIVE

Business

First Name

BRIAN

Middle

DAVID

Last Name

AMUNDSON

Business Name

BRIAN DAVID AMUNDSON

Original Issue Date

12/10/2004

Effective Date

01/05/2026

Expiration Date

03/01/2028

City

LEMONT

State

Zip

60439

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/05/2026