GREGORY B STEPHENSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****87

License Status

NOT RENEWED

Business

First Name

GREGORY

Middle

Last Name

STEPHENSON

Business Name

GREGORY B STEPHENSON

Original Issue Date

09/28/2005

Effective Date

04/13/2012

Expiration Date

03/01/2014

City

CHICAGO

State

Zip

60649

County

COOK

Ever Disciplined

LastModifiedDate

01/25/2017