EMILIE JEANNE ALLEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****42

License Status

NOT RENEWED

Business

First Name

EMILIE

Middle

JEANNE

Last Name

ALLEN

Business Name

EMILIE JEANNE ALLEN

Original Issue Date

03/02/2007

Effective Date

02/08/2018

Expiration Date

03/01/2020

City

MORTON GROVE

State

Zip

60053

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020