PAIGE DELANEY TIEMAN Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****88

License Status

INOPERATIVE

Business

First Name

PAIGE

Middle

DELANEY

Last Name

TIEMAN

Business Name

PAIGE DELANEY TIEMAN

Original Issue Date

09/24/2019

Effective Date

01/23/2020

Expiration Date

03/01/2022

City

CHICAGO

State

Zip

60601

County

COOK

Ever Disciplined

LastModifiedDate

01/03/2022