AMANDA MARIE MILLER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****99

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

MARIE

Last Name

MILLER

Business Name

AMANDA MARIE MILLER

Original Issue Date

05/04/2020

Effective Date

01/17/2022

Expiration Date

03/01/2024

City

CHICAGO

State

Zip

60647

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025