EDWARD W FOWLER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****61

License Status

NOT RENEWED

Business

First Name

EDWARD W

Last Name

FOWLER

Business Name

EDWARD W FOWLER

Original Issue Date

03/13/2001

Effective Date

03/08/2012

Expiration Date

03/01/2014

City

CHICAGO

State

Zip

60608

County

COOK

Ever Disciplined

LastModifiedDate

04/08/2014