TINA M BOUSMAN Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****91

License Status

ACTIVE

Business

First Name

TINA

Middle

Last Name

BOUSMAN

Business Name

TINA M BOUSMAN

Original Issue Date

06/02/2004

Effective Date

02/26/2026

Expiration Date

03/01/2028

City

EVERGREEN PARK

State

Zip

60805

County

COOK

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

02/26/2026