ANDREA POWELL Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****06

License Status

INOPERATIVE

Business

First Name

ANDREA

Last Name

POWELL

Business Name

ANDREA POWELL

Original Issue Date

01/03/2014

Effective Date

01/03/2014

Expiration Date

03/01/2016

City

SKOKIE

State

Zip

60077

County

COOK

Ever Disciplined

LastModifiedDate

01/03/2014