ETHAN JAMES WELLS Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****85

License Status

ACTIVE

Business

First Name

ETHAN

Middle

JAMES

Last Name

WELLS

Business Name

ETHAN JAMES WELLS

Original Issue Date

07/01/2025

Effective Date

07/01/2025

Expiration Date

03/01/2026

City

CHICAGO RIDGE

State

Zip

60415

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025