ARIC BLOM Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****64

License Status

ACTIVE

Business

First Name

ARIC

Last Name

BLOM

Business Name

ARIC BLOM

Original Issue Date

01/15/2010

Effective Date

12/04/2025

Expiration Date

03/01/2028

City

ZION

State

Zip

60099

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/04/2025