MARK SONG Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****15

License Status

ACTIVE

Business

First Name

MARK

Last Name

SONG

Business Name

MARK SONG

Original Issue Date

10/16/2019

Effective Date

01/08/2026

Expiration Date

03/01/2028

City

EVANSTON

State

Zip

60201

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/08/2026