RENATA M BLOCK Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001907

License Status

ACTIVE

Business

First Name

RENATA

Middle

Last Name

BLOCK

Business Name

RENATA M BLOCK

Original Issue Date

10/11/2002

Effective Date

12/03/2025

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60654

County

COOK

Ever Disciplined

LastModifiedDate

12/03/2025