MACIEJ G STANCZAK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****56

License Status

NOT RENEWED

Business

First Name

MACIEJ

Middle

Last Name

STANCZAK

Business Name

MACIEJ G STANCZAK

Original Issue Date

12/13/2017

Effective Date

12/13/2017

Expiration Date

03/01/2020

City

JOLIET

State

Zip

60435

County

WILL

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020