BENJAMIN H ANDERSON 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

BENJAMIN

Middle

Last Name

ANDERSON

Business Name

BENJAMIN H ANDERSON

Original Issue Date

10/01/2013

Effective Date

03/02/2018

Expiration Date

03/01/2020

City

CHICAGO

State

Zip

60618

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020