THOMPSON DZIDZA 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

THOMPSON

Last Name

DZIDZA

Business Name

THOMPSON DZIDZA

Original Issue Date

08/11/2014

Effective Date

12/04/2025

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60640

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/04/2025