MARYAM MICHELLE BEINTEMA Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****82

License Status

ACTIVE

Business

First Name

MARYAM

Middle

MICHELLE

Last Name

BEINTEMA

Business Name

MARYAM MICHELLE BEINTEMA

Original Issue Date

01/16/2025

Effective Date

02/08/2026

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60657

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2026