CONRAD CALVIN LO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****06

License Status

NOT RENEWED

Business

First Name

CONRAD

Middle

CALVIN

Last Name

Business Name

CONRAD CALVIN LO

Original Issue Date

05/03/2005

Effective Date

02/25/2016

Expiration Date

03/01/2018

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

05/10/2018