MATTHEW ALLEN PTACK Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****98

License Status

ACTIVE

Business

First Name

MATTHEW

Middle

ALLEN

Last Name

PTACK

Business Name

MATTHEW ALLEN PTACK

Original Issue Date

03/20/2017

Effective Date

01/25/2026

Expiration Date

03/01/2028

City

SKOKIE

State

Zip

60076

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/25/2026