JENNIFER A LARSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****22

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

Last Name

LARSON

Business Name

JENNIFER A LARSON

Original Issue Date

08/29/2007

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

SKOKIE

State

Zip

60076

County

COOK

Ever Disciplined

LastModifiedDate

12/02/2010