TALIA M MAVROGIANNIS Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****94

License Status

ACTIVE

Business

First Name

TALIA

Middle

Last Name

MAVROGIANNIS

Business Name

TALIA M MAVROGIANNIS

Original Issue Date

06/23/2022

Effective Date

01/24/2026

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60612

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/24/2026