BROOK MARIE ANDERSON Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****44

License Status

ACTIVE

Business

First Name

BROOK

Middle

MARIE

Last Name

ANDERSON

Business Name

BROOK MARIE ANDERSON

Original Issue Date

01/12/2021

Effective Date

02/23/2024

Expiration Date

03/01/2026

City

CHICAGO

State

Zip

60625

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025