LAQUITA C EDWARDS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****46

License Status

NOT RENEWED

Business

First Name

LAQUITA

Middle

Last Name

EDWARDS

Business Name

LAQUITA C EDWARDS

Original Issue Date

04/13/2015

Effective Date

02/23/2018

Expiration Date

03/01/2020

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020