ROBERT EDWARD RYAN Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****64

License Status

INOPERATIVE

Business

First Name

ROBERT

Middle

EDWARD

Last Name

RYAN

Business Name

ROBERT EDWARD RYAN

Original Issue Date

12/19/2017

Effective Date

12/19/2017

Expiration Date

03/01/2020

City

BLUE ISLAND

State

Zip

60406

County

COOK

Ever Disciplined

LastModifiedDate

12/18/2019