Mailing Address Springfield Office: 320 West Washington St Springfield, IL 62786
Chicago Office: James R. Thompson Ctr 100 W. Randolph St Suite 9-300 Chicago, IL 60601
Telephone Springfield Office: (217)785-0800 (217)782-3414 For Real Estate Calls (217)524-6735 TDD (217)782-7645 FAX Chicago: (312)814-4500
Physician Assistant- Acceptance of Examination
THIS PACKET INCLUDES: . Instruction Sheet . Licensure methods and Definitions . Child and Elder Abuse Reporting Notice . Application Jacket . CT Certification of Licensure
Physician Assistant - Endorsement THIS PACKET INCLUDES: . Instruction Sheet . Licensure methods and Definitions . Child and Elder Abuse Reporting Notice . Application Jacket . CT Certification of Licensure
Physician Assistant - Controlled Substances & Legend Drugs THIS PACKET INCLUDES: . Prescriptive Authority for Physician Assistant Midlevel Practioner . Instruction Sheet . Notice of Delegated Prescriptive Authority for Controlled Substances . Notice of Delegated Prescriptive Authority for Controlled Substances . Notice of Termination of Delegated Prescriptive Authority for Legend Drugs and/or Controlled Substances
Physician Assistant - Notice of Prescriptive Authority for Controlled Substances THIS PACKET INCLUDES: . Prescriptive Authority for Physician Assistant Midlevel Practitioner . Instruction Sheet . Notice of Delegated Prescriptive Authority for Controlled Substances
Physician Assistant - Legend Drugs
THIS PACKET INCLUDES: . Prescriptive Authority for Physician Assistant Midlevel Practitioner . Instruction Sheet . Notice of Delegated Prescriptive Authority for Controlled Substances
Physician Assistant - Employment Notification THIS PACKET INCLUDES: . Employment Notification
Physician Assistant - Notification of Termination of Supervisory Control THIS PACKET INCLUDES: . Notification of Termination of Supervisory Control
Restoration Forms must be obtained from the Department of Professional Regulation
