ADAM GRAVES VAUGHAN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****11

License Status

NOT RENEWED

Business

First Name

ADAM

Middle

GRAVES

Last Name

VAUGHAN

Business Name

ADAM GRAVES VAUGHAN

Original Issue Date

11/30/2016

Effective Date

02/14/2018

Expiration Date

03/01/2020

City

MELROSE PARK

State

Zip

60160

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020