MALLORY BETH WEBER Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****28

License Status

ACTIVE

Business

First Name

MALLORY

Middle

BETH

Last Name

WEBER

Business Name

MALLORY BETH WEBER

Original Issue Date

12/14/2016

Effective Date

01/05/2024

Expiration Date

03/01/2026

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

12/03/2025