ERIC ANDREW GIRARDOT 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

First Name

ERIC

Middle

ANDREW

Last Name

GIRARDOT

Business Name

ERIC ANDREW GIRARDOT

Original Issue Date

01/18/2005

Effective Date

12/30/2019

Expiration Date

03/01/2022

City

SKOKIE

State

Zip

60076

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022