DIANE YOUNG Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****04

License Status

NOT RENEWED

Business

First Name

DIANE

Last Name

YOUNG

Business Name

DIANE YOUNG

Original Issue Date

10/22/2018

Effective Date

10/22/2018

Expiration Date

03/01/2020

City

CHICAGO

State

Zip

60614

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020