JASON ALLAN GENCO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****10

License Status

NOT RENEWED

Business

First Name

JASON

Middle

ALLAN

Last Name

GENCO

Business Name

JASON ALLAN GENCO

Original Issue Date

09/18/2015

Effective Date

12/24/2019

Expiration Date

03/01/2022

City

DES PLAINES

State

Zip

60016

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022