COLLEEN M BIRD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****70

License Status

NOT RENEWED

Business

First Name

COLLEEN

Middle

Last Name

BIRD

Business Name

COLLEEN M BIRD

Original Issue Date

10/15/2003

Effective Date

02/10/2022

Expiration Date

03/01/2024

City

GLEN ELLYN

State

Zip

60137

County

KANE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025