MARK DAWYDOWYCZ Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****38

License Status

NOT RENEWED

Business

First Name

MARK

Last Name

DAWYDOWYCZ

Business Name

MARK DAWYDOWYCZ

Original Issue Date

04/02/2018

Effective Date

04/02/2018

Expiration Date

03/01/2020

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020