JENNIFER MARIE WYSONG Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****20

License Status

INOPERATIVE

Business

First Name

JENNIFER

Middle

MARIE

Last Name

WYSONG

Business Name

JENNIFER MARIE WYSONG

Original Issue Date

03/09/2015

Effective Date

01/02/2020

Expiration Date

03/01/2022

City

MELROSE PARK

State

Zip

60160

County

COOK

Ever Disciplined

LastModifiedDate

01/03/2022