AMANDA SUZANNE DVORAK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****91

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

SUZANNE

Last Name

DVORAK

Business Name

AMANDA SUZANNE DVORAK

Original Issue Date

07/11/2018

Effective Date

07/11/2018

Expiration Date

03/01/2020

City

JOLIET

State

Zip

60435

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020