MEGAN A MASK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****86

License Status

NOT RENEWED

Business

First Name

MEGAN

Middle

Last Name

MASK

Business Name

MEGAN A MASK

Original Issue Date

04/03/2012

Effective Date

01/23/2014

Expiration Date

03/01/2016

City

NAPERVILLE

State

Zip

60540

County

DUPAGE

Ever Disciplined

LastModifiedDate

04/25/2016