LAURA THOMETZ PUGLESSI Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****62

License Status

NOT RENEWED

Business

First Name

LAURA

Last Name

THOMETZ PUGLESSI

Business Name

LAURA THOMETZ PUGLESSI

Original Issue Date

03/21/2014

Effective Date

03/06/2018

Expiration Date

03/01/2020

City

MAYWOOD

State

Zip

60153

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020