JASON ROBERT RUBERG Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****92

License Status

NOT RENEWED

Business

First Name

JASON

Middle

ROBERT

Last Name

RUBERG

Business Name

JASON ROBERT RUBERG

Original Issue Date

11/03/2015

Effective Date

01/02/2020

Expiration Date

03/01/2022

City

CHICAGO

State

Zip

60647

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022