ERIC DUSTIN WOOD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****09

License Status

NOT RENEWED

Business

First Name

ERIC

Middle

DUSTIN

Last Name

WOOD

Business Name

ERIC DUSTIN WOOD

Original Issue Date

10/06/2011

Effective Date

01/31/2012

Expiration Date

03/01/2014

City

HAZEL CREST

State

Zip

60429

County

COOK

Ever Disciplined

LastModifiedDate

02/11/2015