DANIEL DOHERTY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****53

License Status

NOT RENEWED

Business

First Name

DANIEL

Last Name

DOHERTY

Business Name

DANIEL DOHERTY

Original Issue Date

09/21/2021

Effective Date

09/21/2021

Expiration Date

03/01/2022

City

CHICAGO

State

Zip

60612

Ever Disciplined

LastModifiedDate

07/27/2022