BLAIR PORTER Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****50

License Status

ACTIVE

Business

First Name

BLAIR

Last Name

PORTER

Business Name

BLAIR PORTER

Original Issue Date

09/23/2024

Effective Date

09/23/2024

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