JACK GLENN HUGULEY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****90

License Status

NOT RENEWED

Business

First Name

JACK

Middle

GLENN

Last Name

HUGULEY

Business Name

JACK GLENN HUGULEY

Original Issue Date

03/02/2010

Effective Date

03/02/2010

Expiration Date

03/01/2012

City

CHICAGO

State

Zip

60605

County

COOK

Ever Disciplined

LastModifiedDate

04/16/2012