WATAN SANDY ABUAITA 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

WATAN

Middle

SANDY

Last Name

ABUAITA

Business Name

WATAN SANDY ABUAITA

Original Issue Date

03/01/2017

Effective Date

02/22/2020

Expiration Date

03/01/2022

City

CHICAGO

State

Zip

60612

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022