JASON M STAFFORD 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

JASON

Middle

Last Name

STAFFORD

Business Name

JASON M STAFFORD

Original Issue Date

01/31/2007

Effective Date

01/31/2007

Expiration Date

03/01/2008

City

MORTON GROVE

State

Zip

60053

County

COOK

Ever Disciplined

LastModifiedDate

11/16/2006