HAROLD EDWIN DURBIN JR Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****13

License Status

NOT RENEWED

Business

First Name

HAROLD

Middle

EDWIN

Last Name

DURBIN JR

Business Name

HAROLD EDWIN DURBIN JR

Original Issue Date

05/28/2020

Effective Date

05/28/2020

Expiration Date

03/01/2022

City

CHICAGO

State

Zip

60611

County

COOK

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

07/27/2022