COREY MICHAEL MERRILL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****25

License Status

NOT RENEWED

Business

First Name

COREY

Middle

MICHAEL

Last Name

MERRILL

Business Name

COREY MICHAEL MERRILL

Original Issue Date

03/12/2015

Effective Date

03/01/2018

Expiration Date

03/01/2020

City

GLENVIEW

State

Zip

60025

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020