AMANDA M GIBBS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****97

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

Last Name

GIBBS

Business Name

AMANDA M GIBBS

Original Issue Date

06/29/2015

Effective Date

03/01/2018

Expiration Date

03/01/2020

City

ARLINGTON HEIGHTS

State

Zip

60005

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020