JOHN L ANCONA Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****73

License Status

INOPERATIVE

Business

First Name

JOHN

Middle

Last Name

ANCONA

Business Name

JOHN L ANCONA

Original Issue Date

03/15/2004

Effective Date

02/09/2016

Expiration Date

03/01/2018

City

OAK LAWN

State

Zip

60453

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2018