BENJAMIN JOSEPH BREWER Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****35

License Status

INOPERATIVE

Business

First Name

BENJAMIN

Middle

JOSEPH

Last Name

BREWER

Business Name

BENJAMIN JOSEPH BREWER

Original Issue Date

09/19/2014

Effective Date

02/05/2016

Expiration Date

03/01/2018

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/02/2018