MARYBETH BOLANOWSKI Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****59

License Status

ACTIVE

Business

First Name

MARYBETH

Last Name

BOLANOWSKI

Business Name

MARYBETH BOLANOWSKI

Original Issue Date

03/13/2001

Effective Date

12/16/2025

Expiration Date

03/01/2028

City

LOMBARD

State

Zip

60148

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/16/2025