MEGAN M JACKLIN Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****71

License Status

INOPERATIVE

Business

First Name

MEGAN

Middle

Last Name

JACKLIN

Business Name

MEGAN M JACKLIN

Original Issue Date

10/15/2010

Effective Date

12/27/2011

Expiration Date

03/01/2014

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

07/12/2012