AMY H WILEY PA-C Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****34

License Status

NOT RENEWED

Business

Title

PA-C

First Name

AMY

Middle

Last Name

WILEY

Business Name

AMY H WILEY PA-C

Original Issue Date

01/11/2019

Effective Date

01/11/2019

Expiration Date

03/01/2020

City

CHICAGO

State

Zip

60622

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020