KATHERINE GWEN THOMPSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001961

License Status

NOT RENEWED

Business

First Name

KATHERINE

Middle

GWEN

Last Name

THOMPSON

Business Name

KATHERINE GWEN THOMPSON

Original Issue Date

12/26/2002

Effective Date

12/26/2002

Expiration Date

03/01/2006

City

PARK RIDGE

State

Zip

60068

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006