GWEN MARIE BEHM 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

GWEN

Middle

MARIE

Last Name

BEHM

Business Name

GWEN MARIE BEHM

Original Issue Date

06/01/2017

Effective Date

03/14/2018

Expiration Date

03/01/2020

City

CHICAGO

State

Zip

60616

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020