EVAN D TKACZYK Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****46

License Status

ACTIVE

Business

First Name

EVAN

Middle

Last Name

TKACZYK

Business Name

EVAN D TKACZYK

Original Issue Date

07/16/2021

Effective Date

12/25/2025

Expiration Date

03/01/2028

City

ST CHARLES

State

Zip

60174

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/25/2025