JEFFERSON KEITH SWISHER Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****56

License Status

INOPERATIVE

Business

First Name

JEFFERSON

Middle

KEITH

Last Name

SWISHER

Business Name

JEFFERSON KEITH SWISHER

Original Issue Date

01/25/2016

Effective Date

02/02/2022

Expiration Date

03/01/2024

City

ELK GROVE VILLAGE

State

Zip

60007

County

COOK

Ever Disciplined

LastModifiedDate

12/06/2023