BROOKE N MARSICO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****23

License Status

NOT RENEWED

Business

First Name

BROOKE

Middle

Last Name

MARSICO

Business Name

BROOKE N MARSICO

Original Issue Date

01/05/2012

Effective Date

01/15/2020

Expiration Date

03/01/2022

City

CHICAGO

State

Zip

60611

County

COOK

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

07/27/2022