ZACHARY ADAM LINES Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****89

License Status

NOT RENEWED

Business

First Name

ZACHARY

Middle

ADAM

Last Name

LINES

Business Name

ZACHARY ADAM LINES

Original Issue Date

01/16/2015

Effective Date

02/23/2018

Expiration Date

03/01/2020

City

CHICAGO

State

Zip

60608

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020