JIAYI TAO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****14

License Status

NOT RENEWED

Business

First Name

JIAYI

Last Name

TAO

Business Name

JIAYI TAO

Original Issue Date

08/16/2019

Effective Date

12/24/2019

Expiration Date

03/01/2022

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022