DANA OLSON PAYNE Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****17

License Status

INOPERATIVE

Business

First Name

DANA

Last Name

OLSON PAYNE

Business Name

DANA OLSON PAYNE

Original Issue Date

07/14/2014

Effective Date

07/14/2014

Expiration Date

03/01/2016

City

BLUE ISLAND

State

Zip

60406

County

COOK

Ever Disciplined

LastModifiedDate

02/01/2016