AUDRA JANESE DUST Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****38

License Status

INOPERATIVE

Business

First Name

AUDRA

Middle

JANESE

Last Name

DUST

Business Name

AUDRA JANESE DUST

Original Issue Date

12/28/2015

Effective Date

03/01/2018

Expiration Date

03/01/2020

City

CHICAGO

State

Zip

60625

County

COOK

Ever Disciplined

LastModifiedDate

12/18/2019