BERNICE IK-JANG MI JOHNSON Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****95

License Status

INOPERATIVE

Business

First Name

BERNICE

Middle

IK-JANG MI

Last Name

JOHNSON

Business Name

BERNICE IK-JANG MI JOHNSON

Original Issue Date

02/14/2003

Effective Date

12/08/2023

Expiration Date

03/01/2024

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

12/08/2023