MEGAN ANN LARSEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****76

License Status

NOT RENEWED

Business

First Name

MEGAN

Middle

ANN

Last Name

LARSEN

Business Name

MEGAN ANN LARSEN

Original Issue Date

11/21/2016

Effective Date

02/14/2018

Expiration Date

03/01/2020

City

CHICAGO

State

Zip

60610

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020