TY MARSHALL Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****99

License Status

ACTIVE

Business

First Name

Last Name

MARSHALL

Business Name

TY MARSHALL

Original Issue Date

09/05/2020

Effective Date

01/30/2026

Expiration Date

03/01/2028

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/30/2026