BRIAN ALLEN BRECKLEY 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

BRIAN

Middle

ALLEN

Last Name

BRECKLEY

Business Name

BRIAN ALLEN BRECKLEY

Original Issue Date

08/16/2018

Effective Date

12/24/2019

Expiration Date

03/01/2022

City

PARK RIDGE

State

Zip

60068

County

COOK

Ever Disciplined

LastModifiedDate

01/03/2022