THOR JALECO Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****08

License Status

ACTIVE

Business

First Name

THOR

Last Name

JALECO

Business Name

THOR JALECO

Original Issue Date

08/22/2025

Effective Date

01/23/2026

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60614

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/23/2026