LINDY JULY BLACKWELL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****50

License Status

NOT RENEWED

Business

First Name

LINDY

Middle

JULY

Last Name

BLACKWELL

Business Name

LINDY JULY BLACKWELL

Original Issue Date

10/29/2008

Effective Date

02/09/2016

Expiration Date

03/01/2018

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2018