CARLY N GIACOMO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****24

License Status

NOT RENEWED

Business

First Name

CARLY

Middle

Last Name

GIACOMO

Prefix

Business Name

CARLY N GIACOMO

Original Issue Date

10/18/2019

Effective Date

02/21/2022

Expiration Date

03/01/2024

City

JOLIET

State

Zip

60435

County

WILL

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025