TATUM JOANNA BOHLS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****74

License Status

NOT RENEWED

Business

First Name

TATUM

Middle

JOANNA

Last Name

BOHLS

Business Name

TATUM JOANNA BOHLS

Original Issue Date

06/15/2015

Effective Date

02/06/2020

Expiration Date

03/01/2022

City

CHICAGO

State

Zip

60647

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022