BENJAMIN LEE STEVENS 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

BENJAMIN

Middle

LEE

Last Name

STEVENS

Business Name

BENJAMIN LEE STEVENS

Original Issue Date

02/23/2015

Effective Date

02/23/2015

Expiration Date

03/01/2016

City

CHICAGO

State

Zip

60622

County

COOK

Ever Disciplined

LastModifiedDate

03/24/2016