MEGAN PAMELA JOHNSON 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

MEGAN

Middle

PAMELA

Last Name

JOHNSON

Business Name

MEGAN PAMELA JOHNSON

Original Issue Date

07/14/2011

Effective Date

02/28/2012

Expiration Date

03/01/2014

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

12/10/2012