ELIZABETH ANNE BRIGHAM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****75

License Status

NOT RENEWED

Business

First Name

ELIZABETH

Middle

ANNE

Last Name

BRIGHAM

Business Name

ELIZABETH ANNE BRIGHAM

Original Issue Date

09/26/2018

Effective Date

02/20/2020

Expiration Date

03/01/2022

City

EVANSTON

State

Zip

60201

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022