DUSTY GOODMAN Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****52

License Status

ACTIVE

Business

First Name

DUSTY

Last Name

GOODMAN

Business Name

DUSTY GOODMAN

Original Issue Date

09/07/2019

Effective Date

02/04/2026

Expiration Date

03/01/2028

City

GLENVIEW

State

Zip

60025

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2026