Collaboration Agreement No:
1283
Confirmation No:
1283_1214C0002595
Section 1 - Physician Assistant Information
Confidential Information redacted.
Section 2 - Primary Practice Setting & Location:
Practice Type:
Urgent Care-Patient First
Facility
Patient First: UC in Aberdeen
Address
995 Hospitality Way
Aberdeen
MD 21001
Is this the location where a copy of your collaboration agreement is on file? NO
A copy (paper or electronic) must be immediately available upon request by the Board.
Location: 5000 Cox Road, Glen Allen, VA 23060
Section 3 - Advanced Duties and Prescriptive and Dispensing Authority
1.Does this Collaboration Agreement include Advanced Duties?
NO
2. Does this Collaboration Agreement include prescriptive authority?
YES
3. Does this Collaboration Agreement include dispensing authority under a physician's active dispensing permit?
YES
Physician's Name: Dr. Isaac Sucbong Yoon | License No: D0046786