BLAIR BOGARD Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****58

License Status

ACTIVE

Business

First Name

BLAIR

Last Name

BOGARD

Business Name

BLAIR BOGARD

Original Issue Date

09/09/2019

Effective Date

12/04/2025

Expiration Date

03/01/2028

City

GLENVIEW

State

Zip

60026

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/04/2025