BEVERLY BERGANOS JOHNSON Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****52

License Status

INOPERATIVE

Business

First Name

BEVERLY

Middle

BERGANOS

Last Name

JOHNSON

Business Name

BEVERLY BERGANOS JOHNSON

Original Issue Date

12/24/2009

Effective Date

02/04/2016

Expiration Date

03/01/2018

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2018