ELISABETH ALTA WISE Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****10

License Status

ACTIVE

Business

First Name

ELISABETH

Middle

ALTA

Last Name

WISE

Business Name

ELISABETH ALTA WISE

Original Issue Date

08/15/2019

Effective Date

01/27/2026

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60622

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/27/2026