SUJITHRA REPRAKASH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****77

License Status

NOT RENEWED

Business

First Name

SUJITHRA

Last Name

REPRAKASH

Business Name

SUJITHRA REPRAKASH

Original Issue Date

09/18/2019

Effective Date

02/13/2020

Expiration Date

03/01/2022

City

CHICAGO

State

Zip

60628

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022