CAROLYN ROSE PUGH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****32

License Status

NOT RENEWED

Business

First Name

CAROLYN

Middle

ROSE

Last Name

PUGH

Business Name

CAROLYN ROSE PUGH

Original Issue Date

01/08/2004

Effective Date

02/21/2018

Expiration Date

03/01/2020

City

ELGIN

State

Zip

60123

County

KANE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020