MEGAN E CZOSEK 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

MEGAN

Middle

Last Name

CZOSEK

Business Name

MEGAN E CZOSEK

Original Issue Date

10/14/2004

Effective Date

02/27/2018

Expiration Date

03/01/2020

City

CHICAGO

State

Zip

60611

County

COOK

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

11/24/2020