ANDREW IVAN MULLEN 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

ANDREW

Middle

IVAN

Last Name

MULLEN

Business Name

ANDREW IVAN MULLEN

Original Issue Date

10/29/2003

Effective Date

01/16/2014

Expiration Date

03/01/2016

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

04/25/2016