ALLISON MARIE BOLDEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****83

License Status

NOT RENEWED

Business

First Name

ALLISON

Middle

MARIE

Last Name

BOLDEN

Business Name

ALLISON MARIE BOLDEN

Original Issue Date

08/02/2017

Effective Date

12/24/2019

Expiration Date

03/01/2022

City

PALOS HEIGHTS

State

Zip

60463

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022