GIRELLE BRIZNET PETERSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****26

License Status

NOT RENEWED

Business

First Name

GIRELLE

Middle

BRIZNET

Last Name

PETERSON

Business Name

GIRELLE BRIZNET PETERSON

Original Issue Date

08/22/2019

Effective Date

08/22/2019

Expiration Date

03/01/2020

City

CAROL STREAM

State

Zip

60188

County

DUPAGE

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

11/24/2020