ILYAS AHMED GUTALE Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****33

License Status

ACTIVE

Business

First Name

ILYAS

Middle

AHMED

Last Name

GUTALE

Business Name

ILYAS AHMED GUTALE

Original Issue Date

12/24/2019

Effective Date

02/27/2024

Expiration Date

03/01/2026

City

SWANSEA

State

Zip

62226

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

12/03/2025