CHELSEA TARA BURTON Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****72

License Status

INOPERATIVE

Business

First Name

CHELSEA

Middle

TARA

Last Name

BURTON

Business Name

CHELSEA TARA BURTON

Original Issue Date

09/05/2012

Effective Date

01/10/2014

Expiration Date

03/01/2016

City

BERWYN

State

Zip

60402

County

COOK

Ever Disciplined

LastModifiedDate

07/01/2014