DEREK LANCE BOHM Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****24

License Status

ACTIVE

Business

First Name

DEREK

Middle

LANCE

Last Name

BOHM

Business Name

DEREK LANCE BOHM

Original Issue Date

01/23/2026

Effective Date

01/23/2026

Expiration Date

03/01/2028

City

ELMHURST

State

Zip

60126

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/23/2026