NOAH RYAN GOSS 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

NOAH

Middle

RYAN

Last Name

GOSS

Business Name

NOAH RYAN GOSS

Original Issue Date

12/21/2011

Effective Date

02/16/2018

Expiration Date

03/01/2020

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

12/18/2019