MELISSA A BLANCO Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****78

License Status

ACTIVE

Business

First Name

MELISSA

Middle

Last Name

BLANCO

Business Name

MELISSA A BLANCO

Original Issue Date

12/06/2006

Effective Date

12/12/2025

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60612

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/12/2025