CASEY NOEL FOX Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****42

License Status

INOPERATIVE

Business

First Name

CASEY

Middle

NOEL

Last Name

FOX

Business Name

CASEY NOEL FOX

Original Issue Date

09/19/2017

Effective Date

02/08/2018

Expiration Date

03/01/2020

City

MORTON GROVE

State

Zip

60053

County

COOK

Ever Disciplined

LastModifiedDate

12/18/2019