LUCAS ROBERT JOSEPHINE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****54

License Status

NOT RENEWED

Business

First Name

LUCAS

Middle

ROBERT

Last Name

JOSEPHINE

Business Name

LUCAS ROBERT JOSEPHINE

Original Issue Date

10/03/2017

Effective Date

10/03/2017

Expiration Date

03/01/2018

City

JOLIET

State

Zip

60435

County

WILL

Ever Disciplined

LastModifiedDate

05/10/2018