TYLER JOSEPH BURG Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****80

License Status

INOPERATIVE

Business

First Name

TYLER

Middle

JOSEPH

Last Name

BURG

Business Name

TYLER JOSEPH BURG

Original Issue Date

01/09/2018

Effective Date

01/14/2020

Expiration Date

03/01/2022

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Ever Disciplined

LastModifiedDate

01/03/2022