BRENNA LAUREN HENNESSEY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006662

License Status

NOT RENEWED

Business

First Name

BRENNA

Middle

LAUREN

Last Name

HENNESSEY

Business Name

BRENNA LAUREN HENNESSEY

Original Issue Date

07/23/2018

Effective Date

01/15/2020

Expiration Date

03/01/2022

City

OAK PARK

State

Zip

91377

Ever Disciplined

LastModifiedDate

07/27/2022