HANNAH BLOOM LANE Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****16

License Status

ACTIVE

Business

First Name

HANNAH

Middle

BLOOM

Last Name

LANE

Business Name

HANNAH BLOOM LANE

Original Issue Date

07/09/2025

Effective Date

02/12/2026

Expiration Date

03/01/2028

City

SKOKIE

State

Zip

60076

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/12/2026