REGINALD DEMOND LEWIS 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

REGINALD

Middle

DEMOND

Last Name

LEWIS

Business Name

REGINALD DEMOND LEWIS

Original Issue Date

01/23/2015

Effective Date

02/05/2016

Expiration Date

03/01/2018

City

CHICAGO

State

Zip

60613

County

COOK

Ever Disciplined

LastModifiedDate

05/10/2018