DUSTIN COREY CONSOL Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****46

License Status

INOPERATIVE

Business

First Name

DUSTIN

Middle

COREY

Last Name

CONSOL

Business Name

DUSTIN COREY CONSOL

Original Issue Date

12/05/2022

Effective Date

12/05/2022

Expiration Date

03/01/2024

City

OAK LAWN

State

Zip

60453

County

COOK

Ever Disciplined

LastModifiedDate

12/27/2023