ALEXANDER STANLEY PORUCZNIK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****60

License Status

NOT RENEWED

Business

First Name

ALEXANDER

Middle

STANLEY

Last Name

PORUCZNIK

Business Name

ALEXANDER STANLEY PORUCZNIK

Original Issue Date

10/31/2019

Effective Date

01/17/2022

Expiration Date

03/01/2024

City

TINLEY PARK

State

Zip

60477

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025