STEPHANIE ZLATA BALUKA 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

STEPHANIE

Middle

ZLATA

Last Name

BALUKA

Business Name

STEPHANIE ZLATA BALUKA

Original Issue Date

01/08/2019

Effective Date

02/01/2022

Expiration Date

03/01/2024

City

BERWYN

State

Zip

60402

County

COOK

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

02/05/2025