ANDREW THOMAS DOHERTY Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****15

License Status

INOPERATIVE

Business

First Name

ANDREW

Middle

THOMAS

Last Name

DOHERTY

Business Name

ANDREW THOMAS DOHERTY

Original Issue Date

09/03/2010

Effective Date

02/25/2016

Expiration Date

03/01/2018

City

AURORA

State

Zip

60506

County

KANE

Ever Disciplined

LastModifiedDate

05/02/2018