KRYSTSINA DZMITRUKOVA 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

KRYSTSINA

Last Name

DZMITRUKOVA

Business Name

KRYSTSINA DZMITRUKOVA

Original Issue Date

04/26/2016

Effective Date

02/27/2018

Expiration Date

03/01/2020

City

CHICAGO

State

Zip

60630

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020