KEVIN ROBERT RUNGE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****93

License Status

NOT RENEWED

Business

First Name

KEVIN

Middle

ROBERT

Last Name

RUNGE

Business Name

KEVIN ROBERT RUNGE

Original Issue Date

10/04/2005

Effective Date

01/05/2022

Expiration Date

03/01/2024

City

BURR RIDGE

State

Zip

60527

County

DUPAGE

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

02/05/2025