ELIZABETH JEANETTE DURHAM Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****19

License Status

INOPERATIVE

Business

First Name

ELIZABETH

Middle

JEANETTE

Last Name

DURHAM

Business Name

ELIZABETH JEANETTE DURHAM

Original Issue Date

11/20/2014

Effective Date

02/09/2016

Expiration Date

03/01/2018

City

MORTON GROVE

State

Zip

60053

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2018