JACK C ENTER JR Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****09

License Status

ACTIVE

Business

First Name

JACK

Middle

Last Name

ENTER

Suffix

Business Name

JACK C ENTER JR

Original Issue Date

01/23/2001

Effective Date

02/27/2024

Expiration Date

03/01/2026

City

CHICAGO

State

Zip

60641

County

COOK

Ever Disciplined

LastModifiedDate

12/03/2025