COLIN WAYNE JOHNSON Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****47

License Status

INOPERATIVE

Business

First Name

COLIN

Middle

WAYNE

Last Name

JOHNSON

Business Name

COLIN WAYNE JOHNSON

Original Issue Date

03/13/2014

Effective Date

02/16/2016

Expiration Date

03/01/2018

City

EVANSTON

State

Zip

60201

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2018